American Journal of Nursing Research
ISSN (Print): 2378-5594 ISSN (Online): 2378-5586 Website: Editor-in-chief: Apply for this position
Open Access
Journal Browser
American Journal of Nursing Research. 2020, 8(2), 151-156
DOI: 10.12691/ajnr-8-2-3
Open AccessArticle

Impact of Surgical Site Infection at Obstetric Department on Healthcare Costs and Patient Outcomes: Retrospective Review

Noha Mohamed Rashed1, and Ahmed El lithy2

1Misr University for Science and Technology, Collage of applied medical Science, Nursing Major, Egypt

2Obstetrics and Gynecology, Cairo University- Kasr-Al Ainy Hospital, Head of Obstetrics emergency department Kasr AlAiny Hospital, Egypt

Pub. Date: January 15, 2020

Cite this paper:
Noha Mohamed Rashed and Ahmed El lithy. Impact of Surgical Site Infection at Obstetric Department on Healthcare Costs and Patient Outcomes: Retrospective Review. American Journal of Nursing Research. 2020; 8(2):151-156. doi: 10.12691/ajnr-8-2-3


Introduction: Morbidity and mortality were associated with increased surgical site infections (SSIs). Besides, it is a financial problem and has a negative impact on patient quality of life (QoL). Aim of study: It was to evaluate the impact of surgical site infection at Obstetric Department on healthcare costs and patient outcomes. Methods: Retrospective descriptive design was used for nine months survey, from October 2018 to Jun 2019. It included all the infected cases at a certain period, conducted through patient’s files and infection control surveillance at Kasr Al Ainy Obstetric Emergency Hospital. Results: SSI rate was around 0.7% per month, with an average length of stay (LOS) of 21 days which affected the patient outcomes. Total cost for antibiotics ranged from 400 to 7800 Egyptian Pounds per patient. Most common pathogens were Acinetobacter baumannii and Escherichia coli (E. coli) found in the environment and food. The most antibiotics used were Flagyl (metronidazole), Rocephin (ceftriaxone) and Unasyn (Ampicillin/Sulbactam). Conclusions: Surgical site infections have bad health and economic impacts. Environmental sanitation, safety measures for intravenous (IV) solutions, corrective department design, implementation of policies and procedures for infection control are highly recommended.

surgical site health infection control quality of life

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


[1]  Horan, T., Gaynes, R., Martone, W., Jarvis, W., & Emori, T. (1992). CDC Definitions of Nosocomial Surgical Site Infections, 1992: A Modification of CDC Definitions of Surgical Wound Infections. Infection Control & Hospital Epidemiology, 13(10), 606-608.
[2]  J.M. Bahia at al. (2017). Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries. Journal of Hospital Infection 96. 1e15.
[3]  Ban KA, Minei JP, Laronga C, Harbrecht BG, Jensen EH, Fry DE, Itani KM, Dellinger EP, Ko CY, Duane TM 2017. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, J Am Coll Surg. 224(1): 59-74.
[4]  A.E. González-Vélez a, M. Romero-Martínb, R. Villanueva-Orbaiz b, C. Díaz-Agero-Pérezc, A. Robustillo-Rodelac, V. Monge-Jodra 2016. The cost of infection in hip arthroplasty: A matched case-control study. Rev Esp Cir Ortop Traumatol. 60(4): 227-233.
[5]  Tanner J, Dumville JC, Norman G, Fortnam M. (2016). Surgical hand antisepsis to reduce surgical site infection. Cochrane Database of Systemic, Issue 1. Art. No.: CD004288.
[6]  Leaper, David; Ousey, Karen (2015). Evidence update on prevention of surgical site infection Current Opinion in Infectious Diseases: April 2015 - Volume 28 - Issue 2 - p 158-163.
[7]  Berríos-Torres SI, Umscheid CA, Bratzler DW, et al 2017: Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, JAMA Surg. 2017; 152(8): 784-791.
[8]  Ansari S, Hassan M, Barry H D, et al. (June 02, 2019) Risk Factors Associated with Surgical Site Infections: A Retrospective Report from a Developing Country. Cureus 11(6): e4801.
[9]  McNeil, S. A., Nordstrom-Lerner, L., Malani, P. N., Zervos, M., & Kauffman, C. A. (2001). Outbreak of Sternal Surgical Site Infections Due to Pseudomonas aeruginosa Traced to a Scrub Nurse with Onychomycosis. Clinical Infectious Diseases, 33(3), 317-323.
[10]  ODOM-FORREN, J. (2006). Preventing surgical site infections. 36(6), 59-63.
[11]  Ariyo, P., Zayed, B., Riese, V., Anton, B., Latif, A., Kilpatrick, C., . . . Berenholtz, S. (2019). Implementation strategies to reduce surgical site infections: A systematic review. Infection Control & Hospital Epidemiology, 40(3), 287-300.
[12]  Webster J., Osborne S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database of Systematic, Issue 2. Art. No.: CD004985.
[13]  Dumville JC, Gray TA, Walter CJ, Sharp CA, Page T, Macefield R, Blencowe N, Milne TKG, Reeves BC, Blazeby J. (2016). Dressings for the prevention of surgical site infection. Cochrane Database of Systematic Reviews, Issue 12. Art. No.: CD003091.
[14]  McDermott K.W., et al. (2017). Overview of Operating Room Procedures during Inpatient Stays in U.S. Hospitals. HCUP Statistical Brief #233. Agency for Healthcare Research and Quality, Rockville, MD. Available from: https://www.hcup- 2014.jsp.
[15]  Najjia N. Mahmoud, Guiping Yang, and William B. Saunders. (2009). Impact of Surgical Site Infections on Length of Stay and Costs in Selected Colorectal Procedures Published Online: 27 De2009.Surgical Infections VOL. 10, NO. 6.
[16]  Abu Sheasha, Ghada & Yassine, Omaima & Anwar, Medhat & Bedwani, Ramez. (2017). Cost of surgical site infection in Egyptian University Hospital: Informing a decision to implement an infection control program using simulation. Operations Research for Health Care. 18.
[17]  Taghreed Adam, David B Evans and Christopher JL Murray. (2003). Econometric estimation of country-specific hospital costs Cost Effectiveness and Resource Allocation, 1
[18]  De Silva, P. M., & Kumar, A. (2019). Signal Transduction Proteins in Acinetobacter baumannii: Role in Antibiotic Resistance, Virulence, and Potential as Drug Targets. Frontiers in Microbiology, 10, 49.
[19]  Brazier, Y. (2017, December 11). "E. coli infection: Symptoms, causes, and treatment." Medical News Today. Retrieved from
[20]  Podschun, R., & Ullmann, U. (1998). Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clinical microbiology reviews, 11(4), 589-603.
[21]  Sun, Y., Wang, H., Tang, Y., Zhao, H., Qin, S., Xu, L., Zhang, F. (2018): Incidence and risk factors for surgical site infection after open reduction and internal fixation of ankle fracture: A retrospective multicenter study. Medicine, 97(7), e9901.