Surgical Site Infections: Socio-clinical, Microbiological and Antibiogram Profile at a Tertiary-Care Hospital in Eastern India

Background: Surgical site infections (SSI) are estimated to be the most prevalent type of healthcare-associated infections, continuing to pose a significant source of morbidity, economic burden, and mortality. Aim: This study aims to estimate the burden of SSI across various surgical specialties, risk factors, distribution of predominant pathogens, and their antibiogram at a tertiary-care hospital in Eastern India. Methodology: This was a descriptive, cross-sectional study conducted over a period of 24 months, from January 2023 to February 2025. All SSI cases were included according to guidelines from the Centers for Disease Control and Prevention. Samples were collected, and organisms were identified and tested for antimicrobial susceptibility using the MicroScan WalkAway® plus system (Beckman Coulter, California, USA). SSI rates were calculated by dividing the number of SSIs by the number of operative procedures and multiplying the result by 100. Results: Of total 6,628 surgeries, 358 cases were identified as SSI, resulting in a rate of 5.4%, with the majority occurring in the orthopaedics department. Smoking, anaemia, and diabetes mellitus were the most prevalent risk factors. Growth was observed in 87%, with Staphylococcus aureus and Escherichia coli being the predominant pathogens. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 45%, and Vancomycin-resistant Enterococcus (VRE) was 20%. Among the Enterobacterales, 70% of Klebsiella spp., 44% of Escherichia coli, and 32% of Proteus spp. were identified as multidrug-resistant (MDR). All isolates of Acinetobacter calcoaceticus-baumannii complex and 35% of Pseudomonas aeruginosa were identified as MDR. Conclusion: The high SSI rates in different departments underscore the need for improved infection control practices and the establishment of a robust antimicrobial stewardship program. Surveillance of SSI cases, along with feedback, and regular auditing of prophylaxis protocols and resistance trends, is essential to reduce their prevalence. Keywords: Surgical site infections; Antimicrobial resistance; Multidrug-resistant; Methicillin-resistant <I>Staphylococcus aureus</I>; Vancomycin-resistant <I>Enterococcus</I>