Department of Surgery, University Hospital of Ioannina and School of Medicine, University of Ioannina, Greece.
Department of Medical Physics, School of Medicine, University of Ioannina, Greece.
J Wound Care. 2021 Apr 2;30(4):268-274. doi: 10.12968/jowc.2021.30.4.268.
Surgical site infections (SSIs) are associated with protracted hospitalisation, antibiotics administration, and increased morbidity and mortality. This work investigated the incidence rate of SSIs in the Department of General Surgery at the University Hospital of Ioannina, Greece, the associated risk factors and pathogens responsible.
In this prospective cohort study, patients who underwent elective procedures under general anaesthesia were enrolled. Risk factors monitored included age, sex, body mass index, smoking, alcohol consumption, preoperative length of stay, chemoprophylaxis, intensive care unit (ICU) stay, American Society of Anesthesiology (ASA) score, and the National Nosocomial Infections Surveillance System (NNIS) basic SSI risk index.
Of the 1058 enrolled patients, 80 (7.6%) developed SSIs. Of the total cohort, 62.5% of patients received chemoprophylaxis for >24 hours. A total of 20 different pathogens, each with multiple strains (n=108 in total), were identified, 53 (49.5%) Gram-negative rods, 46 (42%) Gram-positive cocci, and nine (8.4%) fungi ( spp.). was the prevalent microorganism (24.3%). SSI-related risk factors, as defined by univariate analysis, included: ICU stay, ASA score >2 (p<0.001), NNIS score >0, and wound classes II, III, and IV. Also, serum albumin levels <3.5g/dl were associated with increased rate of SSIs. The multivariate model identified an NNIS score of >0 and wound classes II, III, and IV as independent SSI-related risk factors.
This study showed high SSI rates. Several factors were associated with increased SSI rates, as well as overuse of prophylactic antibiotics. The results of the present study could be a starting point for the introduction of a system for recording and actively monitoring SSIs in Greek hospitals, and implementation of specific guidelines according to risk factors.
手术部位感染（SSI）与延长住院时间、抗生素使用以及发病率和死亡率增加有关。本研究调查了希腊约阿尼纳大学医院普外科的 SSI 发生率、相关危险因素和病原体。
在这项前瞻性队列研究中，纳入了接受全身麻醉下择期手术的患者。监测的危险因素包括年龄、性别、体重指数、吸烟、饮酒、术前住院时间、化学预防、重症监护病房（ICU）停留时间、美国麻醉师协会（ASA）评分和国家医院感染监测系统（NNIS）基本 SSI 风险指数。
在纳入的 1058 名患者中，有 80 名（7.6%）发生了 SSI。在总队列中，62.5%的患者接受了超过 24 小时的化学预防。共鉴定出 20 种不同的病原体，每种病原体都有多个菌株（共 108 株），其中革兰氏阴性杆菌 53 株（49.5%）、革兰氏阳性球菌 46 株（42%）和真菌 9 株（8.4%）。 是最常见的微生物（24.3%）。单因素分析确定的 SSI 相关危险因素包括：入住 ICU、ASA 评分>2（p<0.001）、NNIS 评分>0 以及伤口分类 II、III 和 IV。此外，血清白蛋白水平<3.5g/dl 与 SSI 发生率增加有关。多变量模型确定 NNIS 评分>0 和伤口分类 II、III 和 IV 是 SSI 相关的独立危险因素。
本研究显示 SSI 发生率较高。有几个因素与 SSI 发生率增加以及预防性抗生素的过度使用有关。本研究的结果可能是在希腊医院引入记录和积极监测 SSI 的系统以及根据危险因素实施具体指南的起点。
