INCIDENCE OF SURGICAL SITE NOSOCOMIAL INFECTIONS IN FEMALE AND MALE SURGICAL WARDS OF AHMADU BELLO UNIVERSITY TEACHING HOSPITAL, ZARIA, NIGERIA
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ABSTRACT
Incidence of surgical site nosocomial infections and antibiotics susceptibility profiles of bacterial isolates in Ahmadu Bello University Teaching Hospital, Zaria Kaduna State, Nigeria were investigated. A 2- year retrospective study was carried out followed by 6-months prospective study and then a follow – up study on surgical site nosocomial infection. The retrospective study was carried out by assessing patients’ medical files and microbiology laboratory records, which were analysed for the determination of the prevalence of surgical site nosocomial infections. The results were statistically evaluated using Chi-square test. The prospective study used bacteriological analysis of air in the modular theatre and surgical wards of the Teaching Hospital. A 6 months follow- up study of nosocomial surgical site infections was carried out for patients who underwentelective surgeries with antibiotic prophylaxis, bacteriological monitoring of the surgical sites from time of surgery until the wound healing occurred or on their discharge from the hospital. Antibiotic susceptibility profiles of the bacterial isolates were determined using the agar diffusion methods as described in official monographs. The result of the retrospective study of surgical site nosocomial infections in surgical wards of Ahmadu Bello University Teaching Hospital, Zaria showed prevalence rates of surgical site nosocomial infections, of 10.5 % and 8.32% respectively for the two years. Superficial surgical sites were more frequently infected compared with other sites. The leading causative agents of nosocomial infection in the retrospective study were S. aureus, E.coli, S.epidermidis, and Ps. aeruginosa in decreasing order of frequencies in the two years of study. Antibiotic susceptibility tests showed that all the bacterial isolates were multiple antibiotics resistant (MAR) with more than 65% of the isolates having MAR index > 0.2 in the two years of study. ix The result of the bacteriological study of nosocomial infection in surgical wards of ABUTH, Zaria among patients showed the incidence of nosocomial infection to be 33.0%. S.aureuswas the most commonly isolated organism followed by S.epidermidis. The result of the follow-up study of patients who hadelective surgery and antibiotic prophylaxis in the hospital showed that the risk factors played a significant role in causing surgical site infection. Bacteriology of air atAhmadu Bello University Teaching Hospital, showed that a total of 24 bacteria were isolated both in the wards and the theatre. The results showed that the antibiotic susceptibility profile of most Bacillusspp isolated from the air in the wards and theatres were resistant to all the antibiotics except Ciprofloxacin and Nitrofurantoin of the test antibiotics. All the bacterial isolated from the air were multiple antibiotics resistant (MAR),with MAR index of >0.2. Most of the bacterial isolated from wounds were multiple antibiotics resistant (MAR) with over 68% of the wound pathogen having an MAR index of > 0.2.
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