Antibiotic prophylaxis practices and surgical site infections in urology: a 3-Year retrospective monocentric analysis at a tertiary care center in Burkina Faso

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Résumé

Background Surgical site infections (SSIs) are a major cause of postoperative morbidity in sub-Saharan Africa. This
study aims to evaluate antibiotic prophylaxis practices and factors associated with SSIs in the urology department of
the Yalgado Ouédraogo University Hospital Center (CHU-YO) in Burkina Faso.
Methods A retrospective cross-sectional study was conducted including 341 surgical procedures performed on
patients operated between January 2021 and December 2023. Data were collected from medical records and
analyzed using Epi Info 7.2.5.2. SSIs were identified using Centers for Disease Control and Prevention (CDC) criteria
through review of both inpatient and outpatient records.
Results The mean age was 49.7 ± 19.6 years with a male predominance (79.8%). Overall complete compliance with
antibiotic prophylaxis, defined as adherence to all six French Society of Anesthesia and Intensive Care (SFAR) criteria,
was 41.1%. The incidence of SSIs was 9.4%. Escherichia coli (50%) was the predominant organism. In multivariate
analysis, a preoperative hospital stay ≤ 2 days was associated with a significantly lower risk of SSIs (OR = 0.216; 95% CI:
0.084–0.554; p = 0.001), while compliant antibiotic prophylaxis was protective against SSIs (OR = 0.262; 95% CI: 0.083–
0.825; p = 0.022). Conversely, prolonged preoperative hospitalization (> 2 days) and non-compliance with prophylaxis
protocols significantly increased SSI risk.
Conclusion Non-compliance with antibiotic prophylaxis protocols, as measured by a strict 6-criteria assessment
based on SFAR guidelines, and prolonged preoperative hospitalization significantly increase the risk of SSIs. Improving
adherence to evidence-based guidelines and implementing strategies to reduce preoperative hospital stay are crucial
to lowering SSI rates in this setting

Mots-clés

Antibiotic prophylaxis, Surgical site infection, Urology, Burkina faso, Clinical practice