Burden of Nosocomial Surgical Site Infections at Three Tertiary Hospitals in Copperbelt Province, Zambia

Introduction: Hospital-acquired infections (HAI) are nosocomial infections that develop after 48 hours of admission, and surgical site infections (SSI) are a major and significant contributor, with high morbidity and mortality, catastrophic healthcare costs, prolonged hospital stays, and poor quality of life. This study aimed to determine the prevalence of nosocomial SSI and their susceptibility profiles at three teaching hospitals in Zambia. Methodology: This prospective cohort study was conducted at three tertiary hospitals in the Copperbelt Province of Zambia. Results: A total of 1 122 participants were included in the study. Of these, 468 were female and 654 were male. The prevalence of nosocomial SSI in the three teaching hospitals was 21%, representing 95 of the 478 participants. The five most common cultured organisms were Staphylococcus aureus (23%), Enterobacter agglomerans (14%), Pseudomonas aeruginosa (11%), Proteus mirabilis (10%), and Escherichia coli (9%). Most isolates were sensitive to meropenem (15%), chloramphenicol (15%), metronidazole (15%), and septrin (11%) and were resistant to ciprofloxacin (36%), azithromycin (13%), gentamycin (11%), and penicillin (10%). Conclusion: The prevalence of Nosocomial SSI was 21%. The cultured bacterial isolates were Staphylococcus aereus (23%), Enterobacter agglomerans (14%), Pseudomonas aeruginosa (11%), Proteus mirabilis (10%), and Escherichia coli (9%). Susceptibility results showed sensitivity to meropenem (15%), chloramphenicol (15%), metronidazole (15%), and septrin (11%), and resistance to ciprofloxacin (36%), azithromycin (13%), gentamycin (11%), and penicillin (10%). Our study recommends chloramphenicol or meropenem in combination with metronidazole as first- and second-line treatments, respectively, for nosocomial SSI at the three tertiary hospitals.