Surveillance of clean surgical procedures: An indicator to establish a baseline of a hospital infection problem in a developing country, Iran

Objectives: To establish a baseline of a hospital's problem, it is recommended to conduct a surveillance of clean (class I) surgical procedures. The present study was conducted to determine the infection rate of clean surgical procedures and to estimate the magnitude of nosocomial infection in some Iranian university hospitals. Materials and Methods: A total of 845 clean surgical wound cases were screened for infection by standard microbiological investigations during a 9-month period of time. Results: The overall clean wound infection rate was found to be 4.9, which is comparable to the expected infection rate of 0.8. The most common organisms isolated were Staphylococcus epidermidis (74), Staphylococcus aureus (17) and Enterobacter aerogenes (5). The in-vitro sensitivity of Staphylococcus epidermidis and Staphylococcus aureus to the common antimicrobial drugs showed that they were resistant to penicillin, ampicillin and amoxicillin. Our study revealed that the efficacy of prophylactic antibiotics in preventing wound infection after clean surgical procedures is unquestioned. Conclusions: Having considered the high rate of clean wound infection, a high rate of hospital infection in the region might be inferred. This study calls for the need of a more organized and effective infection control program that includes active infection surveillance in Iran.