title: Bacteriological Profile of Surgical Site Infections and Their Antibiogram: A Study From Resource Constrained Rural Setting of Uttarakhand State, India.
abstract: BACKGROUND
  Surgical site infections (SSI) constitute a major public health problem worldwide and are the second most frequently reported nosocomial infections. They are responsible for increasing the treatment cost, length of hospital stay and significant morbidity and mortality.
  
  
  OBJECTIVE
  To determine the incidence of SSIs and the prevalence of aerobic bacterial pathogens involved with their antibiogram.
  
  
  METHODS
  Samples were collected using sterile cotton swabs from 137 patients clinically diagnosed of having SSIs and were processed as per standard microbiological techniques. Antimicrobial susceptibility testing was done using modified Kirby-Bauer disc diffusion method. This cross sectional study was conducted for a period of six months (January 2013 to June 2013) in the Department of Microbiology at a rural tertiary care hospital of Uttarakhand state, India.
  
  
  RESULTS
  Out of 768 patients, 137 (17.8%) were found to have SSIs and samples were collected from them. Out of total 137 samples, 132 (96.4%) yielded bacterial growth and 139 bacterial isolates were obtained. Staphylococcus aureus (50.4%) was the commonest organism followed by Escherichia coli (23.02%), Pseudomonas aeruginosa (7.9%) and Citrobacter species (7.9%). Antimicrobial profile of gram positive isolates revealed maximum sensitivity to vancomycin, teicoplanin and linezolid, whereas among gram negative isolates meropenem, piperacillin-tazobactam, and amikacin were found to be most sensitive.
  
  
  CONCLUSIONS
  The rate of SSI observed in this study was comparable to other similar studies, however we observed a higher degree of antimicrobial resistance. Adherence to strict infection control measures, maintenance of proper hand hygiene and optimal preoperative, intraoperative and postoperative patient care will surely reduce the incidence of SSIs.
authors.affiliation: Former Junior Demonstrator, Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute , Srinagar Garhwal, Uttarakhand, India .
authors.forename: Vikrant
authors.initials: V
authors.lastname: Negi
authors.affiliation: Associate Professor, Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute , Srinagar Garhwal, Uttarakhand, India .
authors.forename: Shekhar
authors.initials: S
authors.lastname: Pal
authors.affiliation: Senior Demonstrator, Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute , Srinagar Garhwal, Uttarakhand, India .
authors.forename: Deepak
authors.initials: D
authors.lastname: Juyal
authors.affiliation: Senior Demonstrator, Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute , Srinagar Garhwal, Uttarakhand, India .
authors.forename: Munesh Kumar
authors.initials: MK
authors.lastname: Sharma
authors.affiliation: Professor and Head, Department of Microbiology and Immunology, Veer Chandra Singh Garhwali Government Medical Sciences and Research Institute , Srinagar Garhwal, Uttarakhand, India .
authors.forename: Neelam
authors.initials: N
authors.lastname: Sharma
keywords: Antimicrobial resistance; Infection control; MRSA; Nosocomial infection; Post operative wound