Incidence Rate and Risk Factors of Surgical Site Infections: A Microbiological Perspective in a Tertiary Care Hospital

Abstract

Surgical Site Infections (SSIs) account for 20% of healthcare-associated infections (HAIs), contributing to significant morbidity, mortality, and increased healthcare costs, with global incidence rates reaching up to one-third of surgical patients. This study analyzes the incidence of SSIs, associated risk factors, and microbial profile in a tertiary care hospital in North India from January 2023 to October 2024. A cross-sectional observational study was conducted on 3,463 surgeries, with SSIs diagnosed with CDC guidelines and categorized as superficial, deep, or organ/space infections. Patient risk factors, surgical variables, and microbiological findings were analyzed using active and post-discharge surveillance. The overall SSI rate was 1.1 per 100 surgeries (39 cases), with malignancy-related surgeries exhibiting the highest incidence (5.4%). Major risk factors included advanced age, ASA grade ≥3, BMI >25 kg/m², prolonged surgical duration (>4 hours), and elevated postoperative blood glucose levels, while 25.64% of cases showed a significant breach in antibiotic prophylaxis timing. Microbiological analysis identified Klebsiella spp. as the predominant bacterial isolate (48.7%). Despite advancements in surgical and infection control practices, SSIs remain a concern, emphasizing the need for continuous surveillance, timely interventions, and strict adherence to prophylactic protocols to mitigate risk and improve patient outcomes.