SURGICAL SITE INFECTIONS AMONG PATIENTS UNDERGOING GYNECOLOGICAL SURGERIES: PREVALENCE, RISK FACTORS, MICROBIOLOGICAL PROFILE, AND ANTIMICROBIAL RESISTANCE PATTERN – A HOSPITAL BASED CROSS-SECTIONAL STUDY

Abstract

Background: Surgical site infection (SSI) is one of the most common healthcare-associated infections following gynecological surgery and is associated with increased postoperative morbidity, prolonged hospitalization, antimicrobial use, and healthcare costs. Identification of risk factors, causative microorganisms, and antimicrobial susceptibility patterns is essential for implementing effective infection prevention and antimicrobial stewardship strategies. Methods: A hospital-based cross-sectional study was conducted among 45 women undergoing elective or emergency gynecological surgeries at a tertiary care teaching hospital in Chennai, India. Consecutive sampling was employed over a six-month period. Demographic, clinical, surgical, and microbiological data were collected using a structured proforma. Surgical site infections were diagnosed according to the Centers for Disease Control and Prevention (CDC) criteria. Wound swabs obtained from infected patients underwent culture and antimicrobial susceptibility testing. Data were analyzed using SPSS version 25.0. Logistic regression analysis was performed to identify independent predictors of SSI, and a p-value <0.05 was considered statistically significant. Results: The overall prevalence of SSI was 20.0% (9/45). Diabetes mellitus (adjusted OR=12.84, 95% CI: 1.31–125.92; p=0.028), anemia (adjusted OR=5.62, 95% CI: 1.03–30.62; p=0.046), and intraoperative blood loss ≥500 mL (adjusted OR=9.31, 95% CI: 1.45–59.63; p=0.019) were identified as independent predictors of SSI. Staphylococcus aureus was the most frequently isolated pathogen (33.3%), followed by Escherichia coli and Klebsiella pneumoniae (22.2% each). Amikacin demonstrated the highest antimicrobial susceptibility (88.9%), followed by gentamicin and piperacillin tazobactam (77.8% each), whereas ceftriaxone and amoxicillin-clavulanate showed the highest resistance (55.6%). Conclusion: Surgical site infection remains a significant postoperative complication following gynecological surgery. Diabetes mellitus, anemia, and intraoperative blood loss ≥500 mL were the major independent risk factors for SSI. Routine perioperative risk assessment, optimization of patient comorbidities, meticulous intraoperative blood loss control, adherence to evidence-based infection prevention practices, and culture-guided antimicrobial therapy are essential to reduce SSI incidence and improve postoperative outcomes.