SURGICAL SITE INFECTIONS: PREVALENCE, ASSOCIATED FACTORS AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS OF THE BACTERIAL ISOLATES AMONG POSTOPERATIVE PATIENTS IN SANA’A, YEMEN
Authors: Alhadi Yahya Abdullah Ahmed , Al-Kibsi Taghreed Ahmed M , Al-Shamahy Hassan Abdulwahab , Aldeen Yusra Ahmed Ali Sharf 
Published: July 2022

Background: Surgical site infections (SSIs) are infections that occur one month after a surgical operation or one year after implant surgery and a surgical procedure, either at the injury site or near the injury site. Despite SSIs are still a major problem causing increased morbidity and mortality globally, especially in developing countries, there is a dearth of information in Yemen.
Objective: This study was aimed to assess the prevalence of SSIs, associated factors and antimicrobial susceptibility patterns of the bacterial isolates among post-operative patients in public and private hospitals in Sana’a, Yemen.
Methods: This is a cross-sectional study carried out on 309 postoperative patients, aged one year and over that underwent surgery in selected public and private hospitals between January 2019 and January 2020 in Sana’a. Patients’ demographic and clinical information were assessed using an interviewer-administered, pretested, structured questionnaire. Wound swabs and aspirates were collected, placed in Stuart transport media and transferred to the Bacteriology Department of the National Center for Public Health Laboratories in Sana’a for bacterial isolation, identification and antimicrobial susceptibility testing..
Results: The mean age of postoperative patients was 34.0±18.3 (SD) years, age group 25-34 years was 93 (30.1%), and females were 105 (33.8%). Total 309 postoperative patients, 98 (31.7%) presented with SSI. Having postoperative antibiotics (OR=7.0, 95%CI: 4.1-12.0), dirty surgical wound (OR=10.5, 95%CI: 5.0-21.9), emergency surgery (OR=3.1, 95%CI: 1.8-5.1), amputation (OR=2.5, 95%CI: 1.1-5.7), excision (OR=2.2, 95%CI: 1.2-4.0), hospital stay > two weeks (OR=5.2, 95%CI: 2.3-11.1) and having diabetes mellitus (OR=2.2, 95%CI: 1.1-4.7) were factors significantly associated with SSIs.
Conclusion: This study shows a significant proportion of SSIs among patients in Sana’a, Yemen. Being a female, having a dirty surgical wound, amputation, excision, long hospital stays, diabetes mellitus, and emergency surgery appears to be the major factors associated with SSIs. The most common SSI bacterial etiology is S. aureus, sensitive to vancomycin and rifampicin.

Peer Review History:
Received: 10 May 2022; Revised: 12 June; Accepted: 30 June, Available online: 15 July 2022
Academic Editor: Prof. Dr. Gorkem Dulger, Duzce University, Turkey, gorkemdulger@yandex.com
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Received file: Reviewer's Comments:
Average Peer review marks at initial stage: 6.0/10
Average Peer review marks at publication stage: 7.5/10
Reviewers:
Dr. Bountain Welcome Tebeda,Chemical Pathology Department, Federal Medical Centre, Yenagoa, Nigeria. bountaintebeda@yahoo.com
Dr. Esther Marguerite Chase DJANGA, Faculty of Medicine and Biomedical Sciences. Department of Public Health. University of Yaoundé I, Cameroon. e.djanga@yahoo.com
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