Recent studies have revealed that surgical site infection (SSI) rates in India are significantly higher compared to many high-income countries (HICs), posing a substantial challenge to patient safety and healthcare quality nationwide.

Higher SSI Rates in India

While global SSI rates range from 0.5% to 15%, studies in India have consistently reported higher rates, ranging from 23% to 38% . In contrast, SSI rates in HICs typically range between 1.2% and 5.2% .

Contributing Factors

Several factors contribute to the elevated SSI rates in India:

Infection Control Practices: A study in rural and semi-urban hospitals found that while sterilization practices were reportedly followed, awareness about appropriate hand-washing times and utilization of the WHO safety checklist was limited. Additionally, prophylactic antimicrobials were continued postoperatively in over 80% of hospitals, contrary to global guidelines .

Resource Constraints: Limited access to advanced medical facilities and trained healthcare professionals in rural areas exacerbates the problem. A study in a rural teaching hospital reported an SSI rate of 39%, higher than other similar studies in India, highlighting the challenges faced in resource-constrained settings .

Economic Burden: SSIs significantly increase healthcare costs. For instance, the total cost of illness due to post-cesarean SSIs was almost three times higher compared to non-infected matched control groups .

Call to Action

Addressing the high SSI rates in India requires a multifaceted approach:

Enhanced Infection Control Measures: Implementing and strictly adhering to standardized infection control protocols, including proper hand hygiene and the use of surgical safety checklists, is crucial.

Antimicrobial Stewardship: Rationalizing the use of prophylactic antimicrobials to prevent the development of resistant microbial strains and ensure effective infection control.

Resource Allocation: Investing in healthcare infrastructure, especially in rural and semi-urban areas, to provide adequate resources and training for healthcare professionals.

Surveillance and Reporting: Establishing robust SSI surveillance systems to monitor infection rates and identify areas for improvement.

The higher incidence of SSIs in India compared to high-income countries underscores the need for immediate and sustained efforts to improve surgical care quality. By addressing the contributing factors and implementing targeted interventions, India can enhance patient outcomes and reduce the economic burden associated with SSIs.