ICMR Study Finds Surgical Infection Rates in India Exceed Those of Many High-Income Countries

The rate of Surgical Site Infections (SSIs) in three major Indian hospitals was found to be higher than in many high-income countries, according to a study by the Indian Council of Medical Research (ICMR). The research involved 3,020 patients from these hospitals and highlighted the prevalence of SSIs as a significant healthcare-associated infection.

SSIs are known to cause considerable health issues, leading to increased medical costs and longer hospital stays. The study revealed that debridement surgery, often performed with amputation or fixation surgeries, had the highest SSI rate at 54.2%. This highlights the need for better infection control measures in surgical procedures.

SSI Rates and Risk Factors

The research was conducted at Jai Prakash Narayan Apex Trauma Centre, Kasturba Hospital in Manipal, and Tata Memorial Hospital in Mumbai. It showed that SSI rates at these hospitals were higher than those in many high-income countries, where rates typically range from 1.2% to 5.2%. In contrast, the study found an overall SSI incidence of 5.2% among the patients monitored.

In comparison, the SSI rate was lower than Gujarat's 8.95% but higher than Dehradun's 5% in India. It also exceeded rates reported in Iran (17.4%), Egypt (17%), and Pakistan (7.3%). The study authors noted this as India's first multicentric systematic surveillance effort for SSIs.

Post-Discharge Surveillance Findings

The study emphasised the importance of post-discharge surveillance, which identified 66% of SSI cases that might have otherwise gone unnoticed. This surveillance was crucial as there is a lack of data on post-discharge SSIs from low- and middle-income countries like India.

Combination surgeries were found to elevate the risk of SSIs significantly. The research indicated that surgeries lasting over 120 minutes and clean but polluted wound classes were strongly associated with increased SSI risk.

Implications for Healthcare

The absence of a comprehensive post-discharge SSI monitoring system in India prompted this multicentric analysis. The aim was to estimate SSI proportions and identify associated risk factors during hospital stays and after discharge.

Patients who developed SSIs faced extended hospitalisation periods. The study's findings underscore the need for improved infection control practices and robust surveillance systems to manage SSIs effectively.

This research marks a significant step towards understanding and addressing SSIs in India, providing valuable insights into infection control strategies necessary for improving patient outcomes.