Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran.
Department of Vascular Surgery, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Int Wound J. 2023 Sep;20(7):2640-2648. doi: 10.1111/iwj.14137. Epub 2023 Mar 10.
Hospital-acquired infections (HAIs) are considered a major challenge in health care systems. One of the main HAIs, playing an important role in increased morbidity and mortality, is surgical wound infection. Therefore, this study aimed to determine the incidence rate and risk factors of surgical wound infection in general surgery patients. This cross-sectional study was performed on 506 patients undergoing general surgery at Razi hospital in Rasht from 2019 to 2020. Bacterial isolates, antibiotic susceptibility pattern, antibiotic administration, and its type, operation duration and shift, the urgency of surgery, people involved in changing dressings, length of hospitalisation, and levels of haemoglobin, albumin, and white blood cells after surgery were assessed. The frequency of surgical wound infection and its association with patient characteristics and laboratory results were evaluated. The SPSS software package (version 16.0, SPSS Inc., Chicago, IL, USA) was used to analyse the data. Quantitative and qualitative variables were presented using mean (standard deviation) and number (percentage). The Shapiro-Wilk test was used to evaluate the normality of the data in this study. The data did not have a normal distribution. Hence, χ and Fisher's exact tests were used to evaluate the relationship between variables. Surgical wound infection occurred in 4.7% (24 cases) of patients with a mean age of 59.34 (SD = 14.61) years. Preoperative (>3 days) and postoperative (>7 days) hospitalisation, history of immunodeficiency (P < 0.001), and interns responsible for changing dressings (P = 0.021) were associated with surgical wound infection incidence. About 9.5% and 4.4% of surgical wound infection cases were significantly associated with pre- and postoperative antibiotic use. Gram-positive cocci were the most prevalent strains isolated from 24 surgical wound infection cases (15/24, 62.5%). Among these, Staphylococcus aureus was the predominant species, followed by coagulase-negative staphylococci. In addition, the most common Gram-negative isolates identified were Escherichia coli bacteria. Overall, administration of antibiotics, emergency surgery, surgery duration, and levels of white blood cells and creatinine were identified as surgical wound infection-associated risk factors. Identifying important risk factors could help control or prevent surgical wound infections.
医院获得性感染(HAIs)被认为是医疗保健系统面临的主要挑战之一。其中,手术部位感染是主要的医院获得性感染之一,它在增加发病率和死亡率方面起着重要作用。因此,本研究旨在确定普外科患者手术部位感染的发生率和危险因素。本横断面研究于 2019 年至 2020 年在拉什特的拉齐医院对 506 例普外科患者进行。评估了细菌分离株、抗生素药敏模式、抗生素的使用及其类型、手术持续时间和班次、手术的紧急程度、参与更换敷料的人员、住院时间以及术后血红蛋白、白蛋白和白细胞水平。评估了手术部位感染的频率及其与患者特征和实验室结果的关系。使用 SPSS 软件包(版本 16.0,SPSS Inc.,芝加哥,IL,USA)分析数据。定量和定性变量采用平均值(标准差)和数量(百分比)表示。本研究采用 Shapiro-Wilk 检验评估数据的正态性。数据没有正态分布。因此,采用 χ2 和 Fisher 确切检验评估变量之间的关系。手术部位感染发生在 4.7%(24 例)年龄为 59.34 岁(SD=14.61)的患者中。术前(>3 天)和术后(>7 天)住院、免疫缺陷史(P<0.001)和实习医生负责更换敷料(P=0.021)与手术部位感染发生率相关。约 9.5%和 4.4%的手术部位感染病例与术前和术后使用抗生素显著相关。从 24 例手术部位感染病例中分离出的最常见的革兰氏阳性球菌(15/24,62.5%)。其中,金黄色葡萄球菌是主要的分离株,其次是凝固酶阴性葡萄球菌。此外,鉴定出的最常见的革兰氏阴性分离株是大肠杆菌。总的来说,抗生素的使用、急诊手术、手术持续时间以及白细胞和肌酐水平被确定为与手术部位感染相关的危险因素。确定重要的危险因素有助于控制或预防手术部位感染。