Incidence Of Surgical Site Infection Predisposing Factors And Associated Costs At Dessie Referral Hospital Dessie Ethiopia

Background: Surgical wound infection is a prototype of (Hospital Acquired Infection) HAIrnand constitutes a serious problem. Patients diagnosed with Surgical Site Infection (SSI) face a 2rnto 11 times increased in mortality along with prolonged hospital stays, treatment associated risks,rnculture confirmed SSI was 12.1 %. More than half of the bacteria isolated were gram negativernrods. About 79.2 % of all the isolates were Multi Drug Resistant (MDR). About 66.67 % and 100rn% of E. coli and K. pneumonia were Extended Spectrum Beta Lactamase (ESBL) producersrnrespectively. In this study, 55.6 % of the Syaphylococcus species were methicilin resistantrn(MRSA). Hypertension, ASA score-3, elective surgery and the age group 35-44 years were foundrnto be statistically significant associated factors for SSIs. A more than two times increase of therncost and length of hospital stay was observed as a result of SSI in Dessie Referal Hospital.rnConclusion and recommendation: the rate of SSI, MDR, MRSA and ESBL producing bacteriarnwas very high among patients with SSI. A hospital based survey should be conducted on arnregular basis, evidence based information should be given to the surgical team in order to reducernthe rate of SSIs and the use of some drugs should be limited due to a high degree of resistance.rnKey terms: SSI, predisposing factors, drug susceptibility, costrnrnpain, suffering, delayed wound healing, revision of surgery, and potential long-term sequelae.rnThe burdens posed by SSIs are also reflected in excess of health care costs. Advances in controlrnof infections have not completely eradicated the problem because of development of resistance.rnThere are very limited data in relation to this agenda particularly cost associated with SSI inrnEthiopia as well as Africa.rnObjective: The aim of this study was to assess the incidence of surgical site infection,rnpredisposing factors and associated costs at Dessie Referral Hospital, Dessie, EthiopiarnMethods: A hospital based cross sectional study was conducted from July 22 – October 25,rn2016 in Dessie referral hospital. About 338 surgical patients who fulfilled the inclusion criteriarnwere included using consecutive convenient sampling technique. Information regarding socio-rndemographic status and past medical history of the respondent was collected using pre-structuredrnquestionnaire. Two pus swabs were taken when a patient was first presented with clinicalrnevidence of infection. One of the swabs was processed for microscopic examination the otherrnone was inoculated to MacConkey agar, Blood agar and Manitol salt agar following a standardrnoperating procedure. Colony characteristics, Gram’s reaction and biochemical tests were used torndifferentiate the organisms. Antibiotic susceptibility of the isolated bacteria was determined byrnKirby-Bauer disc diffusion technique, following CLSI guideline (CLSI document M100-S24).rnThe data was analyzed by SPSS version 20 and the results were presented by using tables andrndifferent graphs. Logistic regression analysis was used to determine the association betweenrndependent and independent variables.rnResults: out of the 338 patients included in this study 49 (14.5 %) were clinically suspected forrnSSIs. Forty one out of the 49 (83.7 %) wound swabs were culture positive; hence the overall

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