Developing a rational approach to surgical site infection prevention in a tertiary care hospital in Cairo

Surgical site infections (SSI) account for a large proportion of hospital acquired infections. They are associated with high morbidity and mortality that poses a large burden upon inpatient's health care budget.  Prevention is desirable and it consists of a combination of preoperative patient and operation room environment preparation, appropriate surgical techniques, preoperative antibioprophylaxis and postoperative wound care.
Surveillance of SSI was conducted, in a tertiary care hospital in Cairo, as a part of the infection control program. This study represents SSI over 2006 in general and specialized surgeries. Cases were identified according to data analyzed from the infection notification forms and the microbiology reports of positive cultures. The isolated microorganisms as well as their sensitivity/resistance pattern were illustrated. Results showed infection rates in Clean surgeries:
1.05%, Clean-contaminated: 0.8%, Contaminated: 4.7% and Dirty: 8%, in general type of surgery-wound class. Other measures for SSI prevention were highlighted as patient preoperative preparation, biological assessment of operation room environment and antibioprophylaxis which is implemented and properly followed since July 2005 to date.  Cycling of the antibiotic policy was done three times and updated according to new requirements.  Measuring SSI rates is a major challenge in hospitals where limited experience with measurement of outcomes exists. However  it  is  one  of  the  quality  performance  indicators  in  health  care  settings.