The level of microbial contamination and frequency of surgical site infections at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac

Abstract

Introduction. The level of microbial contamination is an important risk factor for surgical site infections. The aim of this study was to investigate the frequency of surgical site infections in regard to the level of microbial contamination at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac. Material and methods. This study included 474 patients who underwent surgery in the period from January 1, 2002 to December 31, 2002 at the Department of Orthopedic and Traumatologic Surgery of the Clinical Hospital Center in Kragujevac. Hospital infections were identified using CDC definitions, modified to fit our circumstances. The traditional classification of surgical sites in regard to the level of microbial contamination includes three categories: clean, contaminated and dirty. Results The incidence of surgical site infections was higher at the Orthopedic Surgery Ward (5.94%) compared to Traumatologic Surgery Ward (5.02%). Additionally, a significantly higher frequency of deep surgical site infections, which were classified as clean were established at the Orthopedic Surgery Ward, in regard to the level of microbial contamination, whereas the greatest frequency of surface infections in clean surgical sites (p=0.000) were established at the Traumatologic Surgery Ward. Surgical site infections were more frequent in patients undergoing multiple surgeries at the Orthopedic Surgery Ward than in those treated at the Traumatologic Surgery Ward (p=0.037). Conclusion It is of utmost importance to estimate the frequency of surgical site infections and identify associated risk factors in order to undertake adequate measures for their prevention and control.

Cilj rada bio je sagledavanje učestalosti infekcija operativnog mesta u odnosu na stepen mikrobne kontaminacije u Centru za ortopediju i traumatologiju Kliničko-bolničkog centra u Kragujevcu. Studijom incidencije infekcija operativnog mesta obuhvaćeno je 474 bolesnika koji su u periodu od 1.01.2002. do 31.12.2002. godine operisani u Centru za ortopediju i traumatologiju Kliničko-bolničkog centra u Kragujevcu. Na odeljenju Ortopedija zabeležena je značajno veća učestalost infekcija operativnog mesta (5,94%) u odnosu na kategoriju operativnog mesta prema stepenu mikrobne kontaminacije, nego na odeljenju Traumatologija (5,02%). Takođe, na odeljenju Ortopedija zabeležena je značajno veća učestalost dubokih infekcija operativnih mesta koja su prema stepenu mikrobne kontaminacije klasifikovana kao čista, dok je na odeljenju Traumatologija u čistih operativnih mesta nađena najveća učestalost površinskih infekcija operativnog mesta (p=0,000). Kod pacijenata koji su imali multiple (>1) operacije značajno češće su registrovane infekcije operativnog mesta na odeljenju Ortopedija nego na odeljenju Traumatologija, pri čemu su operativna mesta uglavnom klasifikovana kao čista (p=0,037).