Keyword: Surgical Site Infection

ABSTRACT: Post-caesarean surgical site infections (SSIs) remain a major cause of maternal morbidity, particularly in low-resource settings, and are increasingly complicated by antimicrobial resistance. This study aimed to determine the antimicrobial susceptibility patterns and prevalence of multidrug resistance among bacterial isolates from post-caesarean SSIs at University College Hospital, Ibadan. A retrospective analysis of 66 laboratory records was conducted, out of which 52 records met the inclusion criteria. Bacterial isolates were identified using appropriate culture plates, and their antimicrobial susceptibility profiles were analysed using standard disk diffusion (Kirby–Bauer) method. A total of 75 isolates were identified, with Gram-negative organisms (68%) predominating over Gram-positive organisms (32%). The most common isolate was Pseudomonas aeruginosa, followed by Escherichia coli, Klebsiella spp, and Staphylococcus aureus. Antimicrobial susceptibility testing revealed high resistance rates to commonly used antibiotics such as amoxicillin, erythromycin, and azithromycin, while better susceptibility was observed with gentamicin, levofloxacin, and vancomycin among Gram-positive isolates. Notably, vancomycin showed 100% susceptibility. Multidrug resistance was highly prevalent, with 74.7% of isolates classified as MDR, indicating resistance to at least one agent in three different antibiotic classes. This high burden of MDR highlights a significant therapeutic challenge and underscores the role of antibiotic misuse and hospital-acquired infections in driving resistance. The findings of this study emphasize the need for routine antimicrobial susceptibility testing, strengthened infection prevention and control measures, and implementation of antimicrobial stewardship programs. Continuous surveillance and policy interventions are essential to mitigate the growing threat of antimicrobial resistance and improve clinical outcomes in post-caesarean SSIs.

ABSTRACT: Background: Device-associated infections remain major complications of medical implants, contributing to prolonged hospitalisation, revision surgery, morbidity, and increased healthcare burden. Biofilm formation provides the biological rationale for antimicrobial implant strategies, although clinical studies often assess downstream infection outcomes rather than direct biofilm measures.
Objectives: This systematic review evaluated the clinical effectiveness, safety, and certainty of evidence for antimicrobial biomaterials and implant surface modification strategies in reducing device-associated infections, reinfection, microbial colonisation, and related complications among human implant recipients.
Methodology: A systematic search of PubMed, ScienceDirect, and Dimensions was conducted for original human studies published between 2015 and 2025. Eligible studies included randomised trials and observational cohorts evaluating antimicrobial biomaterials against conventional, uncoated, or standard-care comparators. Data extraction covered implant type, antimicrobial coating, comparator, infection-related outcomes, adverse events, and follow-up duration. Quality appraisal was performed using RoB 2 and ROBINS-I, while certainty of evidence was assessed narratively. A structured narrative synthesis was conducted because of heterogeneity in implant types, interventions, indications, comparators, and outcome definitions.
Findings: Twenty studies were included. DAC hydrogel coatings showed the most consistent association with reduced surgical site infection, periprosthetic joint infection, reinfection, and complications in selected orthopaedic settings. Silver- and iodine-coated implants showed promise in high-risk oncological reconstruction, while gentamicin-coated nails and calcium sulphate-based strategies appeared useful in trauma fixation and second-stage reimplantation. However, most studies were retrospective or non-randomised, several had serious risk of bias, and none directly quantified biofilm formation.
Conclusion: Antimicrobial biomaterials may reduce infection risk in selected implant settings, especially orthopaedic applications, but broader conclusions require cautious interpretation and stronger prospective evidence.