Incidence of Surgical Site Infections and Associated Risk Factors in General/Surgical Wards in Peshawar

Abstract

Surgical site infections (SSIs) remain a major cause of postoperative complications, leading to increased morbidity, prolonged hospital stays, and higher healthcare costs. This study examines multiple risk factors contributing to SSIs, including patient demographics, surgical history, postoperative  care,  infection  indicators,  healthcare  provider  practices,  antibiotic  resistance patterns, environmental influences, surgical team compliance, and nutritional status. A total of 138 patients undergoing various surgical procedures were analyzed. Data were collected on demographic characteristics, type of surgery, duration of hospital stay, wound care practices, presence  of  infections,  antibiotic  use,  and  compliance  with  infection  control  measures. Microbiological analysis identified common bacterial pathogens and their antibiotic resistance patterns. Environmental conditions and healthcare provider adherence to infection prevention protocols  were  also  assessed.  Statistical  analysis  was  performed  to  determine  significant associations  between  these  factors  and  SSI  incidence.  SSIs  were  confirmed  in  23.2%  of patients, with Staphylococcus aureus (34.4%), Escherichia coli (28.1%), and Pseudomonas aeruginosa  (21.9%)  being  the  most  common  pathogens.  Methicillin-resistant  S. aureus (MRSA) was identified in 41.2% of cases, while fluoroquinolone and carbapenem resistance were prevalent among E. coli and Klebsiella pneumoniae. Key risk factors for SSIs included emergency  surgeries  (34.8%),  prolonged  surgical  duration  (>2  hours,  23.9%),  inadequate postoperative wound care, and poor nutritional status. Environmental conditions, including high  patient  density  and  inadequate  ventilation,  were  also  linked  to  higher  SSI  rates. Compliance with infection control protocols varied, with only 36.2% of suspected infection cases  involving  patient  isolation.  Malnourished  patients  had  a  significantly  higher  SSI incidence (28.6%) and longer recovery times compared to well-nourished individuals. The findings emphasize the need for a multifaceted approach to SSI prevention, incorporating strict infection  control  measures,  antibiotic  stewardship,  environmental  optimization,  and perioperative  nutritional  support.  Strengthening  surgical  team  compliance,  improving postoperative wound care, and addressingmodifiable patient  risk factors can significantly reduce  SSIs  and  enhance  patient  outcomes.  Future  research  should  focus  on  long-term strategies  to  mitigate  antimicrobial  resistance  and  develop  advanced  infection  prevention protocols.