ArticleAntimicrobial resistance and infection control2022
Incidence and risk factors of surgical site infections and related antibiotic resistance in Freetown, Sierra Leone: a prospective cohort study.
Article in Antimicrobial resistance and infection control, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
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Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Prevalence, risk factors, and antimicrobial resistance of endemic healthcare-associated infections in Africa: a systematic review and meta-analysis.BMC infectious diseases · 2024Pooled it
- Geographical mapping and temporal trends of Acinetobacter baumannii carbapenem resistance: A comprehensive meta-analysis.PloS one · 2024Pooled it
- Prevalence and determinants of microbiologically unconfirmed healthcare-associated infections among hospitalized patients in Western Sierra Leone, 2024: a point prevalence survey.Infection prevention in practice · 2026Article
- SurgiCut-AI: an AI-driven tool for predicting surgical site infections following ventral hernia repair using pre- and intra-operative parameters.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Epidemiological patterns, risk factors, and prevention gaps of surgical site infections in operating rooms: a hospital-based surveillance study.Frontiers in public health · 2026Article
- Surveillance of Healthcare-Associated Infections in the WHO African Region: Systematic Review of Literature from 2011 to 2024.Antibiotics (Basel, Switzerland) · 2025Review
- Tackling the disparities in surgical site infections and related antimicrobial resistance in low- and middle-income countries.Surgery in practice and science · 2025Review
- Activating Ferroptosis of M1 Macrophages: A Novel Mechanism of Asiaticoside Encapsuled in GelMA for Anti-Inflammation in Diabetic Wounds.Exploration (Beijing, China) · 2025Article
- Antimicrobial Resistance in Surgical Patients at the University Teaching Hospital of Kigali: A Cross-Sectional Study.The American journal of tropical medicine and hygiene · 2025Article
- Surgical site infections in sub-Saharan Africa: epidemiology, risk factors, and prevention strategies.Annals of medicine and surgery (2012) · 2025Review
- High incidence of multidrug-resistant organisms and modifiable risk factors associated with surgical site infections: a cohort study in a tertiary medical center in Kuala Lumpur, Malaysia from 2020 to 2023.Antimicrobial resistance and infection control · 2025Article
- Article
- Necrotizing Fasciitis: A Retrospective Review of the Microbiological Aspects and Factors Associated with Multi-Drug Resistance from a Saudi Tertiary Care Hospital.International journal of general medicine · 2025Article
- Prevalence and factors of surgical site infections in surgical wards, Windhoek, Namibia.Health SA = SA Gesondheid · 2025Article
- Phage vB_Kpn_HF0522: Isolation, Characterization, and Therapeutic Potential in Combatting K1Infection and drug resistance · 2025Article
- Treatment seeking and antibiotic use for urinary tract infection symptoms in the time of COVID-19 in Tanzania and Uganda.Journal of global health · 2024Article
- Prevalence, resistance profiles and factors associated with skin and soft-tissue infections at Jinja regional referral hospital: A retrospective study.PLOS global public health · 2024Article
- Antimicrobial resistance in bacterial wound, skin, soft tissue and surgical site infections in Central, Eastern, Southern and Western Africa: A systematic review and meta-analysis.PLOS global public health · 2024Article
- Antimicrobial approach of abdominal post-surgical infections.World journal of gastrointestinal surgery · 2023Review
- High incidence of catheter-associated urinary tract infections and related antibiotic resistance in two hospitals of different geographic regions of Sierra Leone: a prospective cohort study.BMC research notes · 2023Article
Corrections and comments
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Authors and funding
25 authors at 7 institutions in 5 countries.
Funding
Abstract
backgroundThere is limited information on surgical site infections (SSI) and the related antibiotic resistance needed to guide their management and prevention in Sierra Leone. In this study, we aimed to establish the incidence and risk factors of SSI and the related antibiotic resistance among adults attending a tertiary hospital, and a secondary health facility in Freetown, Sierra Leone.
methodsThis is a prospective cohort study designed to collect data from adult (18 years or older) patients who attended elective and emergency surgeries at two hospitals in Freetown between February and July, 2021. Data analysis was done using STATA version 16.
resultsOf 338 patients, 245 (72.5%) and 93 (27.5%) had their surgeries at the tertiary and secondary hospitals, respectively. Many were males 192 (56.8%), less than 35 years 164 (48.5%), and 39 (11.5%) developed an SSI. Of the 39 patients who acquired an SSI, 7 (17.9%) and 32 (82.1%) had their surgeries at the secondary and tertiary hospitals, respectively. The incidence of SSI is higher in contaminated 17 (43.6%) than in clean-contaminated 12 (30.8%) and clean 10 (25.6%) wounds. Wound swabs were collected in 29 (74.4%) patients, of which 18 (62.1%) had bacterial growth. In total, 49 isolates of 14 different bacteria including gram-negative 41 (83.7%) and gram-positive 8 (16.3%) isolates were identified. Of these, 32 (65.3%) were Enterobacteriaceae, 9 (18.4%) were Non-fermenting gram-negative bacilli and 10 (12.2%) were Enterococci. The most common isolates were Escherichia coli (12, 24.5%), Klebsiella pneumoniae (10, 20.4%), Acinetobacter baumannii (5, 10.2%), Klebsiella oxytoca (4, 8.2%) and Enterococcus faecalis (4, 8.2%). The Enterobacteriaceae were either resistance to carbapenems (4, 8.2%) or were extended-spectrum beta-lactamase (ESBL) producing organisms (29, 59.2%). Male sex [p = 0.031], an ASA score ≥ 2 [p = 0.020), administration of general anaesthesia [p = 0.018] and elevated fasting glucose [p = 0.033] were predictive of SSI.
conclusionThe incidence of SSI in this study is comparable to other low- and middle-income countries, but a substantial proportion of these postoperative wounds have an ESBL-producing Enterobacteriaceae. Therefore, routine surveillance of SSI and related antibiotic resistance is required in resource-limited settings.
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