Surgical Site Infections and Risk Factors: Results of a State Hospital in the Eastern Anatolia Region in Turkey

Year 2015, , 198 - 203, 27.08.2015

Kasım Çağlayan Ahmet Bal Mehmet Balcı Ergin Arslan Neziha Yılmaz

https://doi.org/10.18229/ktd.61813

Abstract

Objective: Surgical site infections (SSIs) are a major problem after surgery. They cause to impairment of patient
comfort, increase morbidity, mortality, in hospital stay
and costs. The aim of this study is to investigate the risk
factors affecting SSIs.
Material and Methods: One thousand forty patients
underwent general surgery procedures at a single state
hospital between 2007 November and 2009 August were
retrospectively reviewed for SSIs and its relationship with
factors such as age, gender, ASA (American Society of
Anesthesiologists) scores, timing and site of surgery, type
of wound and underlying diseases.
Results: Patients ranged in age from 4 to 82 years (mean
36,1 ±15,8) and female to male ratio was 43/ 57. Of 1040
patients, 53 (5,1 %) had a diagnosis of SSI. The isolated
pathogen in the 39,2 % of the patients who developed
wound infection was S. aureus. The hospital stay was average 7 days in the patients developed SSI while it was 2,7
days in the patients without SSI. The age, wound type,
ASA scores and underlying diseases were found significant in the development of SSIs (p<0,05).
Conclusions: Postoperative wound infection rates in our
patients were in compatible with literature. Patient’s age,
ASA score, wound type and the presence of additional
disease are not changed factors but this risk can be reduced in patients with preoperative antibiotic prophylaxis. 

Keywords

Surgical site infection, incidence, risk factors

Cerrahi Alan İnfeksiyonları ve Risk Faktörleri: Türkiye’de Doğu Anadolu Bölgesinde bir Devlet Hastanesinin Sonuçları

Abstract

Amaç: Cerrahi alan infeksiyonları (CAİ) cerrahiden sonra görülen major bir problemdir. Hasta konforunun bozulmasına, morbidite ve mortalite artışa, hastanede kalış sü- resinin uzamasına ve hastane maliyetlerinde artışa neden olurlar. Bu çalışmanın amacı cerrahi alan infeksiyonlarını etkileyen risk faktörlerini araştırmaktır.

Materyal ve Metod: Bir devlet hastanesinde Kasım 2007 ile Ağustos 2009 tarihleri arasında cerrahi uygulanan 1040 hasta; CAİ ve onunla ilişkili yaş, cinsiyet, ASA derecelendirmesi, anestezi tipi, cerrahinin zamanlaması ve bölgesi, yara tipi ve altta yatan hastalık açısından retrospektif olarak incelendi.

Bulgular: Hastaların yaşları 4 ile 82 yıl (ort. 36,1 ±15,8 yıl) arasında ve kadın/erkek oranı 43/57 idi. 1040 hastanın 53’ünde (% 5,1) CAİ tanısı konmuştu. CAİ gelişen vakaların % 39,2’sinde S. aureus izole edildi. CAİ gelişen hastaların ortalama yatış süresi 7 gün iken, gelişmeyen hastalarda bu oran 2,7 gün idi. Yaş, yara tipi, ASA skoru ve altta hastalıkla CAİ gelişmesi arasında anlamlı fark bulundu (p<0,05).

Sonuç: Hastaların ameliyat sonrası CAİ oranları literatür ile uyumlu idi. Hastanın yaşı, ASA skoru, yara tipi ve ek hastalık varlığı faktörleri değiştirilmez. Ancak CAİ için risk ameliyat öncesi antibiyotik profilaksisi ile azaltılabilir.

Keywords

Cerrahi alan infeksiyonu, insidans, ced in patients with preoperative antibiotic prophylaxis

References

• Uzunköy A. Surgical site infections: risk factors and methods of prevention. Ulus Travma Acil Cerrahi Derg 2005;11(4):269-81.
• Haridas M, Malangoni MA. Predictive factors for surgical site infection in general surgery. Surgery 2008;144(4): 496-50
• Ozgun H, Ertugrul BM, Soyder A, Ozturk B, Aydemir M. Peri-operative antibiotic prophylaxis: Adherence to guidelines and effects of educational intervention. Int J Surg 2010; 8(2): 159-63.
• Beldi G, Bisch-Knaden S, Banz V, Mühlemann K, Candinas D. Impact of intraoperative behavior on surgical site infections. Am J Surg 2009;198(2):157-62.
• Yoshida M, Nabeshima T, Gomi H, Lefor AT. Technology and the prevention of surgical site infections. J Surg Educ 2007;64(5):302-10.
• Sganga G. New perspectives in antibiotic prophylaxis for intra-abdominal surgery. J Hosp Infect 2002;50: 17-21.
• Nichols RL. Preventing Surgical Site Infections: A Surgeon’s Perspective. EmergInfect Dis 2001;7(2):220-4.
• Stratchounski LS, Taylor EW, Dellinger EP, Pechere JC. Antibiotic policies in surgery: a consensus paper. Int J Antimicrob Agents 2005;26(4):312–22.
• Willemsen I, van den Broek R, Bijsterveldt T, et al. A standardized protocol for perioperative antibiotic prophylaxis is associated with improvement of timing and reduction of costs. J Hosp Infect 2007;67(2): 156-60.
• Golembiewski JA. Antibiotic Prophylaxis for of 3,000 surgical wounds. Tunis Med 2000;78(11):634–40.
• Preventing Surgical Site Infection, J PeriAnesth Nurs wound infection in digestive surgery. Retrospective study 2004;19(2):111-3.
• Yasunaga H, Ide H, Imamura T, Ohe K. Accuracy of economic studies on surgical site infection. J Hosp Infect 2007;65(2):102-7.
• Bratzler DW, Houck PM: Surgical Infection prevention guidline writers workgroup. Antimicrobial prophylaxis for surgery: an advisory statementfrom the national surgical İnfection prevention project. Am J Surg 2005;189(4):395– 40 de Lissovoy G, Fraeman K, Hutchins V, et al. Surgical site infection: Incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009;37(5):387
• Hawn MT, Gray SH, Vick CC, et al. Timely administration of prophylactic antibiotics for major surgical procedures. J Am Coll Surg 2006;203(6):803–11.
• Whitman G, Cowell V, Parris K, McCullough P, Howard T, Gaughan J, et al. Prophylactic Antibiotic Use: Hardwiring of Physician Behavior, Not Education, Leads to Compliance. J Am Coll Surg 2008;207(1):88–94.
• Quinn A, Hill AD, Humphreys H. Evolving issues in the prevention of surgical site infections. Surgeon 2009;7(3):170-2.
• Brown S, Kurtsikashvili G, Alonso-Echanove J, et al. Prevalence and predictors of surgical site infection in Tbilisi, Republic of Georgia. J Hosp Infect 2007;66(2):160
• National Nosocomial Infections Surveillance (NNIS) Report: Data summary from October 1986-April 1996, issued May 1996: A report from the National Nosocomial
• Infections Surveillance (NNIS) System. Am J lnfect Control 1996;24:380-8.
• Razavi SM, Ibrahimpoor M, Sabouri Kashani A, Jafarian A. Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital. BMC Surg 2005;27:2.
• Nathens AB, Dellinger EP. Surgical site infections. Cure Treatment Options Infect Dis 2000;2(4):347-58.
• Culver DH, Horan TC, Gaynes RP, et al. Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 1991;91(3):152-7.
• Spelman DW, Russo P, Harrington G, et al. Risk factors for surgical wound infection and bacteraemia following coronary artery bypass surgery. Aust NZJ Surg 2000;70(1):47-51.
• Blumetti J, Luu M, Sarosi G, et al. Surgical site infections after colorectal surgery: do risk factors vary depending on the type of infection considered? Surgery 2007;142(5): 704 –11.
• Kasatpibal N, Jamulitrat S, Chongsuvivatwong N. Standardized incidence rates of surgicalsite infection:A multicenter study in Thailand. Am J Infect Control 2005;33(10):587-94.
• Kirkland KB, Briggs JP, Trivette SL, Wilkinson WE, Sexton DJ. The impact of surgical site infections in the 1990s: Attributable mortality, excess length of hospitalization and extra costs. Infect Control Hosp Epidemiol 1999;20(11):725-30.