Surgical site infections and other healthcare related infections in cohort of urological patients, 2010-2013

Abstract

Background: Surgical site infections (SSIs) and other healthcare related infections continues to be significant problem in surgical patients across the globe. Aim: To analyze and compare the surveillance data from large cohort of patients operated in Clinic for Urology, Military Medical Academy Methods: A prospective cohort study was performed to identify incidence rate and risk factors for surgical site infections (SSI) from 2010 to 2013. Infection control personal collected general and healthcare related data about patients. The microbiologic testing was performed at the Institute of Medical Microbiology by routine methods. Results: A total of 3823 surgical procedures (3288 patients) were included in the study. The lowest incidence rate was observed in kidney surgery (total nephrectomy - 2.4% and partial nephrectomy - 3.6%), and highest during bladder surgery (total cystectomy - 21.6% and partial cystectomy - 23.5%). The postoperative infections (RR: 2.018; 95%:1.111 -3.666; SE: 0.305; p: 0.021), dra inage (RR:10.417; 95%CI:4.339 - 25.011; SE: 0.447; p: 0.000), preoperative length of hospital stay (RR:0.909; 95%CI: 0.880 - 0.939; SE: 0.017; p: 0.000) and total length of hospitalization (RR:1.140; 95%CI:1.117-1.164; SE: 0.010; p:0.000), as well as contamination class (RR:1.633; CI95%:1.215 - 2.194; SE:0.151; p:0.001) are independent risk factors for SSI in this cohort of patients. Incidence rate of diarrhea caused by Clostridium difficile was 5.01 to 10 000 patient days. The most common cause of SSI and urinary tract infections was Klebsiella spp. Conclusion: The greater attention has been given to adherence to recommendations for the prevention and control of SSIs as well as management of multidrug resistant organisms in urology department.