Incidence and risk factors of surgical site infections and related antibiotic resistance in Freetown, Sierra Leone: a prospective cohort study
Sulaiman Lakoh,Le Yi,Stephen Sevalie,Xuejun Guo,Olukemi Adekanmbi,Isaac O Smalle,N. Williams,U. Barrie,Celesis Koroma,Yongxiang Zhao,Matilda N. Kamara,Constance A. Cummings-John,Darlinda F. Jiba,Enanga Sonia Namanaga,Betsy Deen,Ju-ling Zhang,Anna Maruta,Christiana Kallon,Peng Liu,Haja Wurie,Joseph Sam Kanu,Gibrilla F. Deen,Mohamed Samai,Foday Sahr,Emmanuel Firima +24 more
TLDR
In this paper , the authors aimed to establish the incidence and risk factors of surgical site infections and related antibiotic resistance among adults attending a tertiary hospital, and a secondary health facility in Freetown, Sierra Leone.Abstract:
There is limited information on surgical site infections (SSI) and the related antibiotic resistance needed to guide their management and prevention in Sierra Leone. In this study, we aimed to establish the incidence and risk factors of SSI and the related antibiotic resistance among adults attending a tertiary hospital, and a secondary health facility in Freetown, Sierra Leone.This is a prospective cohort study designed to collect data from adult (18 years or older) patients who attended elective and emergency surgeries at two hospitals in Freetown between February and July, 2021. Data analysis was done using STATA version 16.Of 338 patients, 245 (72.5%) and 93 (27.5%) had their surgeries at the tertiary and secondary hospitals, respectively. Many were males 192 (56.8%), less than 35 years 164 (48.5%), and 39 (11.5%) developed an SSI. Of the 39 patients who acquired an SSI, 7 (17.9%) and 32 (82.1%) had their surgeries at the secondary and tertiary hospitals, respectively. The incidence of SSI is higher in contaminated 17 (43.6%) than in clean-contaminated 12 (30.8%) and clean 10 (25.6%) wounds. Wound swabs were collected in 29 (74.4%) patients, of which 18 (62.1%) had bacterial growth. In total, 49 isolates of 14 different bacteria including gram-negative 41 (83.7%) and gram-positive 8 (16.3%) isolates were identified. Of these, 32 (65.3%) were Enterobacteriaceae, 9 (18.4%) were Non-fermenting gram-negative bacilli and 10 (12.2%) were Enterococci. The most common isolates were Escherichia coli (12, 24.5%), Klebsiella pneumoniae (10, 20.4%), Acinetobacter baumannii (5, 10.2%), Klebsiella oxytoca (4, 8.2%) and Enterococcus faecalis (4, 8.2%). The Enterobacteriaceae were either resistance to carbapenems (4, 8.2%) or were extended-spectrum beta-lactamase (ESBL) producing organisms (29, 59.2%). Male sex [p = 0.031], an ASA score ≥ 2 [p = 0.020), administration of general anaesthesia [p = 0.018] and elevated fasting glucose [p = 0.033] were predictive of SSI.The incidence of SSI in this study is comparable to other low- and middle-income countries, but a substantial proportion of these postoperative wounds have an ESBL-producing Enterobacteriaceae. Therefore, routine surveillance of SSI and related antibiotic resistance is required in resource-limited settings. read more
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How Well Are Hand Hygiene Practices and Promotion Implemented in Sierra Leone? A Cross-Sectional Study in 13 Public Hospitals
Sulaiman Lakoh,Anna Maruta,Christiana Kallon,Gibrilla F. Deen,James A. Russell,Bobson Derrick Fofanah,I. Kamara,Joseph Sam Kanu,Dauda M. Kamara,Bailah Molleh,Olukemi Adekanmbi,Simon Tavernor,Jamie A. Guth,Karuna D. Sagili,Ewan Wilkinson +14 more
TL;DR: Evaluating hand hygiene practices and promotion across public health hospitals in the Western Area of Sierra Leone in a cross-sectional study using the WHO hand hygiene self-Assessment framework in May 2021 found tertiary hospitals were poorly rated in the reminders in workplace and institutional safety climate domains but excelled in training and education.
Journal ArticleDOI
High levels of surgical antibiotic prophylaxis: Implications for hospital-based antibiotic stewardship in Sierra Leone
Sulaiman Lakoh,Joseph Sam Kanu,S. Conteh,James A. Russell,Stephen Sevalie,C. Williams,U. Barrie,Aminata Kadie Kabia,Fatmata Conteh,Mohamed Boie Jalloh,Gibrilla F. Deen,Mustapha Sundifu Kabba,Aiah Lebbie,I. Kamara,Bobson Derrick Fofanah,Anna Maruta,Christiana Kallon,Foday Sahr,Mohamed Samai,Olukemi Adekanmbi,Le Yi,Xuejun Guo,Rugiatu Z. Kamara,Darlinda F. Jiba,Joseph Okeibunor,George A. Yendewa,Emmanuel Firima +26 more
TL;DR: A high rate of antibiotic consumption for surgical prophylaxis is reported, most of which was not based on local guidelines, to address this growing threat of antibiotic resistance in sub-Saharan Africa.
Journal ArticleDOI
The burden of surgical site infections and related antibiotic resistance in two geographic regions of Sierra Leone: a prospective study
Sulaiman Lakoh,Le Yi,James A. Russell,Ju-ling Zhang,Stephen Sevalie,Yongxiang Zhao,Joseph Sam Kanu,Peng Liu,S. Conteh,C. Williams,U. Barrie,Mohamed Gbessay Sheku,Mohamed Boie Jalloh,Olukemi Adekanmbi,Darlinda F. Jiba,Matilda N. Kamara,Gibrilla F. Deen,Joseph Okeibunor,George A. Yendewa,Xuejun Guo,Emmanuel Firima +20 more
TL;DR: In this paper , the burden of surgical site infections and related antibiotic resistance in the 34 Military Hospital (MH) and Makeni Government Hospital (MGH) located in two geographic regions of Sierra Leone using a prospective study design to collect data from adults aged 18 years or older.
Journal ArticleDOI
Antibacterial and Antivirulence Activities of Acetate, Zinc Oxide Nanoparticles, and Vitamin C Against E. coli O157:H7 and P. aeruginosa
Selwan Hamed,Mohamed Emara +1 more
TL;DR: In this article , the antibacterial activity of sodium acetate (NaA), vitamin C (VC), and zinc oxide nanoparticles (ZnO NPs) against Escherichia coli O157:H7 ATCC 51659 and Pseudomonas aeruginosa ATCC 27853 were evaluated.
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Colistimethate sodium-chitosan hydrogel for treating Gram-negative bacterial wound infections.
Aathira Pradeep,Nivethitha Ashok,V. Sangeetha Priya,Anoop Vasudevan Pillai,Riju R. Menon,RV Jayakumar +5 more
TL;DR: In this paper , a high-end antibiotic loaded chitosan hydrogel was used for the treatment of Gram-negative bacterial infected wounds. But, the effectiveness of the prepared hydrogels was evaluated against both ATCC (American Type Culture Collection) strains and clinical isolates of Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae.
References
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Journal ArticleDOI
CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting.
TL;DR: In this paper, the NHSN criteria for all healthcare-associated infections (HAIs) are presented, including those for the "Big Four" (surgical site infection [SSI], pneumonia [PNEU], bloodstream infection [BSI] and urinary tract infection [UTI]).
Journal ArticleDOI
The European Centre for Disease Prevention and Control (ECDC) pilot point prevalence survey of healthcare-associated infections and antimicrobial use
Peter Zarb,Peter Zarb,Bruno Coignard,J Griskeviciene,Arno Muller,Vanessa Vankerckhoven,Klaus Weist,M. Goossens,S. Vaerenberg,Susan Hopkins,Boudewijn Catry,Dominique L Monnet,Herman Goossens,Carl Suetens +13 more
TL;DR: A standardised methodology for a combined point prevalence survey (PPS) on healthcare-associated infections (HAIs) and antimicrobial use in European acute care hospitals developed by the European Centre for Disease Prevention and Control was piloted across Europe.
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Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries
TL;DR: It is indicated that SSIs are extremely costly and rigorous procedures must be implemented to minimize SSIs, and more economic and QoL studies are required to make accurate cost estimates and to understand the true burden of SSIs.
Journal ArticleDOI
Incidence of and risk factors for incisional hernia after abdominal surgery
Keita Itatsu,Yukihiro Yokoyama,Gen Sugawara,H. Kubota,Y. Tojima,Yasuhiro Kurumiya,H. Kono,H. Yamamoto,Masahiko Ando,Masato Nagino +9 more
TL;DR: A small number of studies have estimated the incidence of incisional hernia after abdominal surgery, but these studies are small in comparison with the need to investigate further the cause of hernia.