Background: Surgical site infection (SSI) poses a serious threat in Neurosurgery. The mere presence of SSI would warrant a prompt medical and/ or surgical intervention for the outcome is very poor. This study aims to establish whether a pre-operative hospital stay of >7 days & other risk factors predisposes to surgical site infections. Methods: Retrospective, cross-sectional study of all pediatric patients who underwent clean neurosurgical procedures for the first time from January 1, 2011- June 30, 2014, in the Philippine General Hospital. The primary outcome was the development of a surgical site infection within 30 days from spine surgery or 90 days from intracranial surgery. Univariate and multivariate logistic regression analyses were performed to show the association of demographic and clinical factors with the development of SSI. Results: 279 medical charts were available for review. Median age was 1 year(5 days to 18 years old). The overall prevalence rate of SSI was 11.26%. Patients with >7 days pre-operative hospital stay had an incidence rate for SSI of 76.47% compared to 23.53% in patients with <7 days pre-operative hospital stay (OR 1.61, CI 0.68-3.84, p=0.280). Conclusions The incidence of SSI is high compared to other centers. There was no association of preoperative hospital stay with SSI. The association was significant only for the history of nosocomial infection. Early pre-operative clearance and surgery are recommended. Further prospective studies and surveillance are warranted
Surgical Wound Infection ; Cross Infection

Background: Mastectomy is a common surgical procedure done worldwide. Surgical site infection (SSI) is a common healthcare-associated infection. Mastectomy SSIs are frequently under-reported.

Objectives: The study aimed to determine the incidence of SSI among mastectomy cases of the Department of Surgery, University of the Philippines - Philippine General Hospital (UP-PGH) during one year of full implementation of the Surgical Site Infection Surveillance Program and evaluate the program's surveillance follow-up rate.

Methods: This study was an observational practice audit research that included all adult patients who underwent a mastectomy in UP-PGH from January 1, 2018, to January 31, 2019, when the SSI Surveillance Program was fully implemented. SSI was monitored and assessed during the patient's hospital stay, on the day of hospital discharge, and at 30 days (± 2 days) after surgery, either during an outpatient visit or via phone call by a nurse navigator. SSI frequency for mastectomy was computed both during the in-hospital stay and at 30 days after surgery. Surveillance follow-up rate, defined as the proportion of patients who could follow-up up to 30 days after surgery, was determined.

Results: The 30-day SSI rate for mastectomy was 6.8% (19/279). All 279 patients were followed up to 30 days after surgery. Of the 279 patients, 277 (99.3%) were through clinic visits, one was through phone calls, and one was still admitted to the hospital.

Conclusion: Full implementation of the SSI Surveillance Program for mastectomy in UP-PGH for one year showed a higher SSI rate than in published international literature. The program had a complete 30-day patient follow-up, contributing to more accurate SSI reporting. Implementing an SSI surveillance program with standardized protocols, dedicated personnel, patient education component, and the analysis of the information derived from such programs can improve an institution's quality of surgical care.

Objective: The use of antimicrobial prophylaxis to prevent surgical site infections (SSI) is well established. This study examined the association of adherence to antimicrobial prophylaxis for clean neurosurgeries with post-operative surgical site infection (SSI) rates. Methods: A retrospective descriptive study was conducted at the Philippine General Hospital (PGH) among pediatric patients who underwent clean neurosurgical procedures between January 1, 2018 – December 31, 2019. The outcome measured was the development of SSI. Univariate and multivariate analysis was performed to show the association of risk factors with SSI. Compliance to existing antibiotic prophylaxis recommendation was assessed. Results: One hundred eighty-nine (189) medical charts were reviewed. Overall prevalence of SSI was 9.5% and fever was the most common initial symptom of SSI. Staphylococcus species was identified from cultures of surgical sites, consistent with existing literature, however gram-negative organisms including multidrug-resistant organisms (MDRO) were noted. All cases received prophylactic antibiotics, but adherence to all parameters (antimicrobial choice, dose, timing, route, re-dosing and duration of prophylaxis) was low at 7.9%. Appropriate antibiotics were prescribed in only 15.9% and antibiotics were discontinued beyond 24 hours post-surgery in 45.5% of cases. Patients who received a regimen fully compliant with antimicrobial prophylaxis recommendations did not develop SSI. Conclusion Adherence to existing antimicrobial prophylaxis protocol for neurosurgeries is low at 7.9%. Patients who received a regimen fully compliant with the recommendations did not develop SSI. Interventions to improve compliance to antimicrobial prophylaxis guidelines are needed.
Surgical Wound Infection

Background and Objectives: Surgical site infection (SSI) makes up the largest single group of postoperative infective complications. For surgeries classified as clean surgeries of the head and neck, such as a thyroidectomy, the routine administration of antimicrobial prophylaxis is not recommended. Despite this, extended usage of antibiotics is common in developing countries. This study evaluated the need for antibiotics in elective transcervical thyroidectomy for the prevention of SSI in a tertiary government hospital in a developing country. Methods: This is a retrospective cohort study that included patients who have undergone elective transcervical thyroidectomy at the Department of Otolaryngology - Head and Neck Surgery (ORL-HNS) of the University of the Philippines - Philippine General (UP-PGH) Hospital from August 1, 2020 to June 30, 2022. Data collection was conducted through review of both in-patient and out-patient records. Results: The data of 58 patients were analyzed. The mean (±SD) age was 42.5±14.5 years, with approximately 2:27 male to female ratio. Of the 58 patients, 26 were given postoperative antibiotics while 32 did not receive postoperative antibiotics. None of the 58 were noted to have SSI on the 3rd postoperative day. Only 54 patients completed the 7-day follow-up of the study and their data were further analyzed. One patient had SSI. There was no significant difference between the presence and absence of postoperative antibiotics in relation to SSI (p-value>0.05). Conclusion This study shows that in patients undergoing transcervical thyroidectomies, there is no significant difference in the occurrence of SSI among patients who received and did not receive postoperative antibiotics. Therefore, there is no need to administer postoperative antibiotics, as long as a sterile surgical technique is ensured.
Surgical Wound Infection ; Thyroidectomy

The occurrence of post-operative wound infection was studied respectively over an eight month period in the University Hospital, Kuala Lumpur. One hundred and seventy four (3.4%) surgical wounds out of 5129 operations became infected. The clean wound infection rate was 2.9%, rising to 5.4% and 12.2% for clean-contaminated and contaminated surgical wounds respectively. Of the wound infections, 80.8% occurred within the first two weeks post-operatively. Bacteriological studies revealed that the commonest bacterial isolates were Staphylococcus aureus (36.1%), Pseudomonas aeruginosa (15.4%) and Klebsiella species (10.1%).
seconds ; Wound Infection ; After values ; Surgical wound ; Surgical Wound Infection

A study on the postoperative patients in the Thai Nguyen central hospital, Ha Tay general hospital has shown that the rate of anaerobic bacterial infected incisions was 55-71%. The common bacterials infected comprised S. aureus (35.87%), E. coli (14.13%). E. spp (11.96%), P. aeruginosa (10.87%) and other bacterials (1.09-5.43%).
Bacterial Infections ; Surgical Wound Infection

Evaluation of the presence and resistance of E.coli in some specimens of surgical infection in Viet Duc Hospital, Military Hospital No.103 and Central Military Hospital No.108. The results showed that: E.coli was present in 23% of surgical infection’s specimens. Among 310 E.coli strains isolated from these specimens, the distribution of E.coli was different: E.coli in bile solution was 28.1%, in urine and pus were 21.3%. E.coli isolated from other specimens accounted low rate. Surgical infection induced E.coli was high sensitivity with netilmycine, amikacine, cefotaxime, gentamicine, norfloxacine and high resistance to ampicilline, co-trimoxazol, chloramphenicol and tetracycline.
Surgical Wound Infection ; Escherichia coli

In search of the best preventive measures against postoperative wound infections, the author has conducted a series of studies which preliminary results are as follows. (1) There were no postoperative secondary infections in 50 surgical cases except in one, which had undergone dacryocystorhinostomy. (2) More than one strain of microorganism were isolated from all of 20 operator's nostril, throat, and peritonsillar region. It is strongly suggested that operators and hospital workers play an important role in the cause of hospital infection. (3) Some difference in the strain of organisms isolated were noted between the countrymen and townsmen. (4) It is urged to pay particular attention to sterilization for lowere abdominal surgery. (5) Chloramphenicol exerted an sustained and excellent broadspectrum antimicrobial activity to various microorganisms.
Chloramphenicol ; Coinfection ; Cross Infection ; Dacryocystorhinostomy ; Pharynx ; Sterilization ; Surgical Wound Infection ; Wound Infection* ; Wounds and Injuries*

The study retrospectively reviewed 1,029 general surgery operations performed from September 1, 1991 to May 31, 1993 to find out the association between the occurrence of surgical site infection (SSI) and the Centers for Disease Control-National Nosocomial Infection Surveillance (CDC-AWS) surgical patient risk index scores. The index assigned 1 point for each of 3 risk factors: 1) American Society of Anesthesiologists (ASA) preoperative assessment class 3, 4 or 5; 2) an operational classified as either contaminated or dirty-infected; 3) an operation with a duration longer than a specified increased with increasing contamination (p=0.000) as well as increasing index scores (p=0.000). Looking at operations within the same category of contamination, SSI rates also increased with increasing scores among clean operations (p=0.944), clean-contaminated operations (p=0.000), contaminated operations (p=0.559), and dirty operations. SSI rates in this hospital series were compared to the 44-hospital CDC-NNIS report.

Background: Healthcare-associated infections (HAIs) among patients in surgical wards are serious complications that do not only affect surgical outcomes, but also increase medical care costs. Objective: To determine the proportion of patients with HAIs in surgery wards and identify factors associated with HAIs. Design: Cross-sectional study. Setting: Department of Surgery, Southern Philippines Medical Center, from January 2016 to December 2016. Participants: 182 patients from different surgical wards. Main outcome measures: Presence of HAI; prevalence odds ratios (POR) of having an HAI for selected factors. Main results: There were 182 patients (122 males and 62 females; mean age 34.89 ± 20.56 years) included in this report. Seventeen patients (9.34%) developed HAI during admission. Among patients who underwent surgery (n=126), having an HAI was significantly associated with: operation time >180 minutes (adjusted POR=15.18; 95% CI 3.92 to 58.69; p=0.0001), >4 surgical team members (adjusted POR=5.42; 95% CI 1.37 to 21.41; p=0.0158), general anesthesia (adjusted POR=10.46; 95% CI 1.29 to 84.63; p=0.0278), and use of inhalational anesthesia (adjusted POR=11.81; 95% CI 1.45 to 96.08; p=0.0210). Conclusion In this study, 9.34% of patients had an HAI during admission. Long hospital stay, use of indwelling medical devices, long surgical procedures, high number of surgical team members during surgery, general anesthesia, and use of inhalational anesthesia are all associated with having an HAI.
Surgical Wound Infection ; Cross Infection ; Pneumonia ; Anesthesia, General