Incidence and Etiology of Surgical Site Infections in Appendectomies: A 3-Year Prospective Study.

OBJECTIVES: Surgical site infections (SSIs) constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period (January 2013 to December 2015) in a community hospital in Qatar, and compare this with external benchmarks.

METHODS: We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control. Information about age, sex, smoking habits, diabetes mellitus status, body mass index, and the result of bacteriologic studies were collected.

RESULTS: Of a total 603 patients, 22 (3.6%) cases of SSI were reported, with an infection rate of 13.6%, 4.5%, and 1.0% in 2013, 2014, and 2015, respectively. SSIs were observed more frequently in patients with contaminated/dirty wounds (6.6%). About 65% of isolates from the surgical site were multidrug-resistant organisms (Escherichia coli and Klebsiella spp.).

CONCLUSIONS: This study describes the incidence of SSI in appendectomy, which could be used as a benchmark for the facility improvement program. The high frequency of multidrug-resistant organisms in SSIs requires additional studies focused on evaluating the effectiveness of the current preventive practices with a particular reference to antimicrobial prophylaxis.