Microbial Trends and Risk Analysis of Surgical Site Infections in Various Post-operative Orthopedic Surgeries in a Tertiary Care Teaching Hospital: A Non-interventional Study

Introduction: Surgical site infections (SSIs) pose a major challenge in orthopedic surgeries in India, with infection rates varying across hospitals. High infection rates in certain settings emphasize the need for effective surveillance and infection control measures. The presence of multidrug-resistant strains further complicates treatment, making continuous monitoring and antibiotic stewardship essential. This study aimed to determine the bacteriological profile, SSI rates, antibiotic susceptibility, and associated risk factors to improve infection prevention and management strategies in orthopedic surgeries. Material and Methods: This study was conducted as an active surveillance program in a tertiary care hospital to monitor surgical site infections (SSI) in orthopedic patients. Patients were systematically assessed postoperatively, and suspected SSIs were identified based on clinical symptoms. Data collection included demographic details, surgical and anesthesia type, risk factors, and wound classification. Standard preoperative protocols, antibiotic prophylaxis, and microbiological analysis were followed for infection detection. Statistical analysis using SPSS software assessed SSI incidence and associated risk factors, with p < 0.05 considered significant. Results: Our study found an SSI incidence of 5.5% among 180 orthopedic patients, with the highest infection rate observed in patients aged 0-25 (8.82%). Staphylococcus aureus (60%), was the most frequently isolated pathogen, followed by Pseudomonas aeruginoa (30%) and Acinetobactor spp. (10%), indicating the need for targeted infection control strategies. Among surgical procedures, Plate/K-wire fixation had the highest SSI rate (9.45%), followed by implant removal (5.26%). The SSI rate was significantly associated with prolonged hospital stay (>6 days: 13.8%), emergency surgeries (66.6%), general anesthesia (25%), dirty wounds (75%), and prolonged surgical duration (>2 hours: 50%) (p < 0.0001). While diabetes (50%) showed an increased risk, their association was not statistically significant (p = 0.4003). Conclusion: Effective infection control strategies, risk assessment, and optimized surgical protocols are essential to reduce SSIs in orthopedic patients, particularly in high-risk cases such as emergency surgeries, prolonged hospital stays, and contaminated wounds.