St. Luke's Provincial Hospital, 33-100 Tarnów, Poland.
State Higher Vocational School, 33-100 Tarnów, Poland.
Int J Environ Res Public Health. 2020 May 2;17(9):3167. doi: 10.3390/ijerph17093167.
Introduction Surgical site infections (SSIs) are a predominant form of hospital-acquired infections in surgical wards. The objective of the study was analysis of the incidence of SSI in, both primary and revision, hip and knee arthroplasties.
The study was conducted in 2012-2018 in a Trauma and Orthopedics Ward in Tarnów according to the methodology of the Healthcare-Associated Infections Surveillance Network (HAI-Net), European Centre for Disease Prevention and Control (ECDC).
The surveillance comprised 2340 surgery patients, including: 1756 Hip Arthroplasties (HPRO) and 584 Knee Arthroplasties (KPRO). In the group of patients under study, 37 cases of SSI were detected, including: 26 cases of SSI after HPRO and 11 cases in KPRO. The average incidence of SSI amounted to 1.6% (1.5% HPRO and 1.9% KPRO) and in-hospital incidence density rates were 1.23 and 1.53 per 1000 patient-days, respectively. Median age of surgical patients in both HPRO and KPRO was 70 years. Women were undergoing arthroplasty surgery more often than men, HPRO ( < 0.05) and KPRO ( < 0.001). Patients with SSI stayed in the ward longer (SSI-HPRO, < 0.001) (SSI-KPRO < 0.01). In KPRO operations, the incidence of SSI was higher than expected, calculated according to the Standardized Infection Ratio (SIR). The most common etiologic agents isolated from SSIs in both HPRO and KPRO were coagulase-negative staphylococci.
Establishing a thorough surveillance of hospital-acquired infections that takes into consideration epidemiological indicators is indispensable to properly assess the epidemiological situation in the ward. The optimal solution is to carry out long-term and multi-center surveillance in the framework of a uniform program, however, even results of single-center studies provide valuable data indicating challenges and needs in improving patient safety.
分析初次和翻修髋关节和膝关节置换术后手术部位感染（SSI）的发生率。
该研究于 2012 年至 2018 年在塔尔努夫的创伤和骨科病房按照医疗保健相关感染监测网络（HAI-Net）和欧洲疾病预防控制中心（ECDC）的方法进行。
该监测包括 2340 例手术患者，包括：1756 例髋关节置换术（HPRO）和 584 例膝关节置换术（KPRO）。在研究组患者中，共发现 37 例 SSI，包括：26 例 HPRO 后 SSI 和 11 例 KPRO 后 SSI。SSI 的平均发生率为 1.6%（HPRO 为 1.5%，KPRO 为 1.9%），住院期间的发病率密度分别为每 1000 患者日 1.23 和 1.53。HPRO 和 KPRO 中手术患者的中位年龄均为 70 岁。女性接受关节置换手术的频率高于男性（HPRO，<0.05）和 KPRO（<0.001）。发生 SSI 的患者在病房停留的时间更长（SSI-HPRO，<0.001）（SSI-KPRO，<0.01）。在 KPRO 手术中，SSI 的发生率高于预期，根据标准化感染比（SIR）计算。从 HPRO 和 KPRO 中分离的 SSI 最常见的病原体是凝固酶阴性葡萄球菌。
建立考虑流行病学指标的医院获得性感染的全面监测对于正确评估病房的流行病学情况是必不可少的。最佳解决方案是在统一计划框架内进行长期和多中心监测，但是，即使是单中心研究的结果也提供了有价值的数据，表明在提高患者安全性方面存在挑战和需求。
