Al-Mulhim Fahad A, Baragbah Mohammed A, Sadat-Ali Mir, Alomran Abdallah S, Azam Md Q
1 Department of Orthopaedic Surgery, College of Medicine, King Fahd Hospital of the University, Al Khobar, Saudi Arabia.
Int Surg. 2014 May-Jun;99(3):264-8. doi: 10.9738/INTSURG-D-13-00251.1.
Surgical site infection (SSI) is disastrous in orthopedic practice as it is difficult to rid the bone and joint of the infection. This study was aimed to assess the prevalence of SSI in orthopedic practice and to identify risk factors associated with surgical site infections. All patients admitted to the orthopedic male and female wards between January 2006 and December 2011 were included in the study group. The data, which were collected from the medical charts and from the QuadraMed patient filing system, included age, sex, date of admission, type of admission (elective versus emergency), and classification of fractures. Analyses were made to find out the association between infection and risk factors, the χ (2) test was used. The strength of association of the single event with the variables was estimated using Relative Risk, with a 95% confidence interval and P < 0.05. A total of 79 of 3096 patients (2.55%) were included: 60 males and 19 females with the average age of 38.13 ± 19.1 years. Fifty-three patients were admitted directly to the orthopedic wards, 14 were transferred from the surgical intensive care unit, and 12 from other surgical wards. The most common infective organism was Staphylococcus species including Methicillin Resistant Staphylococcus aureus (MRSA), 23 patients (29.11%); Acinetobacter species, 17 patients (21.5%); Pseudomonas species, 15 patients (18.9%); and Enterococcus species, 14 patients (17.7%). Fifty-two (65.8%) had emergency procedures, and in 57 patients trauma surgery was performed. Three (3.78%) patients died as a result of uncontrolled septicemia. SSI was found to be common in our practice. Emergency surgical procedures carried the greatest risk with Staphylococcus species and Acinetobacter species being the most common infecting organisms. Proper measures need to be undertaken to control infection rates by every available method; antibiotics alone may not be sufficient to win this war.
手术部位感染(SSI)在骨科医疗实践中是灾难性的,因为很难清除骨骼和关节的感染。本研究旨在评估骨科医疗实践中SSI的患病率,并确定与手术部位感染相关的危险因素。2006年1月至2011年12月期间入住骨科男女病房的所有患者均纳入研究组。从病历和QuadraMed患者档案系统收集的数据包括年龄、性别、入院日期、入院类型(择期与急诊)以及骨折分类。进行分析以找出感染与危险因素之间的关联,采用χ²检验。使用相对风险估计单个事件与变量的关联强度,置信区间为95%,P<0.05。3096例患者中共有79例(2.55%)被纳入:男性60例,女性19例,平均年龄38.13±19.1岁。53例患者直接入住骨科病房,14例从外科重症监护病房转入,12例从其他外科病房转入。最常见的感染病原体是葡萄球菌属,包括耐甲氧西林金黄色葡萄球菌(MRSA),23例患者(29.11%);不动杆菌属,17例患者(21.5%);假单胞菌属,15例患者(18.9%);肠球菌属,14例患者(17.7%)。52例(65.8%)进行了急诊手术,57例患者接受了创伤手术。3例(3.78%)患者因败血症失控死亡。在我们的医疗实践中发现SSI很常见。急诊手术风险最大,葡萄球菌属和不动杆菌属是最常见的感染病原体。需要采取适当措施,通过各种可用方法控制感染率;仅靠抗生素可能不足以赢得这场战斗。