Microorganisms Isolated from Port Site Infection: AclinicoMicrobiological Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2017, Vol 16, Issue 10
Abstract
Background: Port-site infection (PSI) is a prevailing, chronic, nagging, treatment refractory complication of laparoscopic cholecystectomies. It neutralizes the advantages of minimally invasive surgery and increases morbidity, treatment cost of patient, leading to loss of confidence on operating surgeon, patients and common people. PSIs are preventable with appropriate preoperative, intraoperative, and postoperative measures. Not only Atypical Mycobacterium but also a lot of non-mycobacterial pathogens are associated with nonhealing postlaparoscopic wound infections, causing outbreaks or sporadic cases worldwide. Aim: In our retrospectively studied we tried to isolate the microorganisms from the port site wounds, their magnitude, planning for adequate management and to recommend the measures to prevent them in future in our tertiary health care centre in a rural setup. Methods: This observation and investigation based study carried by the Department of General Surgery at MaldaMadical College Hospital, Malda, West Bengal over a period of 3 years (July 2014 to June 2017). The study was carried out in 200 patients who underwent laparoscopic cholecystectomy by our team. 19 cases out of 200 patients presented with chronic pus discharge from either one or all ports which delayed onset and not responding to antibiotics. The pus was collected from all 19 PSI patients and examined for isolation and identification of the causative agents. Gram stain and Ziehl–Neelsen staining methods were used for direct examination. Culture media included blood agar, Robertson's cooked meat broth, MacConkey agar, and Lowenstein–Jensen medium in our hospital.The pus also sent to a standard laboratory for DNA-PCR which is not available in our hospital, for more specific isolation of microorganism. Results: Of the 19 cases, the pus/discharge specimens examined in the form of direct staining and microscopy, culture and DNA-PCR study for isolation and identification of organism. 13 patients showed non-specific bacterial infections in the form of both Gr +ve and Gr –ve respectively 6(45%) and 4(30.67%). Three of the cases had mixed infection of Staphylococcus aureus andPseudomonas spp. with NTM. Six (15%) cases were diagnosed as Mycobacterial infections. Out of six, 5(83.33%) patients were infected with Atypical Mycobacteria. All these isolates were rapid growers most of them belong to either Mycobacterium fortuitum or Mycobacterium abscessus. Conclusions: Our present study shows, the PSI dramatically should be reduced by adopting strict antiseptic measure, with no compromise on sterilization or by using disposable instruments. The use of advanced sterilization systems like STERRAD, which utilises gas plasma technology to kill spores at low temperatures, or using ethylene oxide gas for sterilization of insulated laparoscopic instruments.
Authors and Affiliations
Dr. Pabitra Kumar Goswami, Dr. ParthaPratim Mandal, Dr. Prasanta Kumar Roy
Keywords
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- EP ID EP244067
- DOI 10.9790/0853-1610070107
- Views 50
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