Surgical site infection surveillance in orthopedic patients in the Military Medical Academy, Belgrade
Ministry of Defance, Serbia
Background/Aim. Active surveillance is an important com-ponent of surgical site infection (SSI) reduction strat-egy. The aim of this study was to analyze and compare SSI surveillance data in orthopedic patients in the Military Medical Academy (MMA), Belgrade. Methods. A 4-year prospective cohort study was performed to identify the in-cidence rate and risk factors for SSI in orthopedic patients in the MMA, Belgrade. We col-lected data regarding pa-tients characteristics, health care and micro-organisms iso-lated in SSI. The National Nosocomial In-fection Surveil-lance (NNIS) risk index was subsequently calcu-lated for each patient. The Centers for Disease Control and Preven-tion criteria were used for the diagnosis of SSI. Re-sults. Assessment of 3,867 patients after different orthopedic operations revealed SSI in 109 patients. The overall incidence rate of SSI was 2.8% with the decrease from 4.6% in 2007 to 1.6% in 2010. Using NNIS risk index for surgical procedures there were: 53.7% (2,077) patients with risk 0 – the incidence rate of 1.4%; 38.9% (1,506) patients with risk 1 – the incidence rate of 3.1%; 7.3% (281) patients with risk 2 – the incidence rate of 11.7%; 0.1% (3) patients with risk 3 – without infection within the risk. Multivariate logistic regression analysis identi-fied 6 independent risk factors associated with SSI: contami-nated or dirty wounds, smoking, preoperative infection, NNIS risk index, body mass index and the length of hospital stay. Conclusion. The results of our study are valuable confirma-tion of relations between risk factors and SSI in orthopedic pa-tients. A decreasing incidence rate of SSI (from 4.6% to 1.6%) during a 4-year active surveillance approved its implementation as an important component of SSI reduction strategy.
orthopedic procedures; surgical wound infection; risk factors; serbia