Surgical Site Infection Control Research Articles

A Sensor for Monitoring the Antimicrobial Activity of Wound Dressings for Both Surgical Site Infections (SSIs) and Chronic Wounds.

Antimicrobial impregnated wound dressings are a critical tool for the management, prevention, and control of surgical site infections (SSIs) and infected chronic wounds. However, the sustained therapeutic antimicrobial activity of the dressing when employed for extended periods cannot be readily determined in vivo. Consequently, dressings are changed frequently to ensure that their antimicrobial activity is maintained. Whilst frequent dressing changes allow the wound to be assessed, this is time-consuming and can cause disruption to the wound bed impairing the healing process. Furthermore, this increases medical costs for the patient and hospitals. This paper introduces a novel concept to monitor the therapeutic levels of an antimicrobial component within a wound dressing ensuring the wound dressing remains "fit for purpose" and avoiding indiscriminate use of antiseptics. This could help to inform clinicians whether the antimicrobial is still being delivered at therapeutic levels and as such when to change the dressing ensuring timely positive clinical outcomes. Silver has been used historically as an antimicrobial agent and is ubiquitous in current generations of antimicrobial wound dressings. However, its activity is complex due to the poor solubility of silver ions in the presence of chloride and the effect of complexation by other components in the dressing and wound ecosystem, not least by serum proteins. In this paper, we detail an electrochemical silver sensor (5D patent protected - WO2023275553A1), constructed using a platinum (Pt) nanoband array electrode, and characterise its response to silver ions. This is determined in the presence of bovine serum albumin (BSA) and simulated wound fluid (SWF) containing chloride and rationalised using atomic analysis of the composition of the SWF. The sensor response in SWF is compared with the antimicrobial activity of silver against Pseudomonas aeruginosa in the planktonic and biofilm state, as a function of the amount of silver nitrate added. At low concentrations, silver in SWF has good solubility but reduced antimicrobial effect due to binding of silver by BSA as shown by the sensor response. At intermediate concentrations, above 10ppm, the silver was efficacious on both planktonic microorganisms and biofilm impregnated with microorganisms and readily detected with the sensor. At high concentrations, silver precipitates and both the silver in solution and the sensor response plateaus. The data demonstrates how the sensor correlates with the antimicrobial activity of the silver in vitro and how this could be used to actively monitor antimicrobials in vivo.

Back to Bessic (Bendan Surgical Site Infection Control) for Surgical Site Infection Prevention with Pip-Ed (Pre, Intra, and Post Operative Education) Guideline: New Innovation Idea

Hospital as a health service unit that provides services in general and special fields, one of which is operating room services. The biggest issue in this installation is surgical wound infection, where many factors influence this condition. Education to patients and families regarding information on surgical wound infections can be given starting from before rehabilitation, during surgery and after the rehabilitation process. Education can provide an overview of surgical wound infections so that patients or families can do things according to existing guidelines so that surgical wound infections can be prevented. A new innovation regarding guidelines in patient education in preventing surgical wound infections called BeSSIC (Bendan Surgical Site Infection Control) with the PIP-ED (Pre, Intra, and Post- Operative Education) guideline provides an overview of educational checklists that must be given before, when and after the operation took place.

Back to Bessic (Bendan Surgical Site Infection Control) for Surgical Site Infection Prevention with Pip-Ed (Pre, Intra, and Post Operative Education) Guideline: New Innovation Idea

Back to Bessic (Bendan Surgical Site Infection Control) for Surgical Site Infection Prevention with Pip-Ed (Pre, Intra, and Post Operative Education) Guideline: New Innovation Idea

Topical use of hyperoxygenated fatty acids decreases surgical site infection in patients following laparoscopic cholecystectomy. A randomized controlled trial

BackgroundTo date, the topically effect of hyperoxygenated fatty acids (HOFA) on the control of surgical site infection (SSI) is still unclear. ObjectiveTo assess the effect of topical application of a HOFA solution on the umbilical trocar site after laparoscopic cholecystectomy on SSI. The occurrence of trocar site incisional hernia (TSIH) was also analyzed. MethodsA prospective, double-blind, randomized trial was conducted in patients undergoing laparoscopic cholecystectomy, who also presented at least one of the following associated risk factors for SSI and TSIH such as Body Mass Index (BMI) above 30 kg/m2, Diabetes Mellitus (DM), age over 65 years and Chronic Obstructive Pulmonary Disease (COPD). Patients were randomly allocated to topical application of a HOFA solution (HOFA arm) or saline physiological solution (non-HOFA arm) during closure of the umbilical trocar site with a polypropylene mesh. SSI was the primary outcome. TSIH was also assessed as a secondary outcome. Results103 patients were included, 51 (49.5%) in the HOFA group and 52 (50.5%) in the non-HOFA group. SSI rate was significantly lower in the HOFA group in comparison with the non-HOFA group (19.6% vs. 3.8%; p = 0.028). TSIH rates were similar in both groups (3.8% vs. 2%). Multivariate analyses showed that only HOFA decreased significantly SSI rate. ConclusionTopical application of a HOFA solution at the umbilical trocar site after laparoscopy cholecystectomy decreased SSI rate.

Investing in surgical site infection control toward safe surgery and universal health coverage

Surgical site infection (SSI) is a common but preventable complication after surgery and is a major cause of postoperative morbidity and mortality in low-and middle-income countries. Antimicrobial resistance (AMR) rates are also high in the setting. To scale up access to surgical care toward achieving the goals of universal health coverage, several countries in the setting have created surgical plans. These plans aim to significantly increase surgical volumes. These countries must scale up infection prevention and control programs at the same pace to avoid uncontrollable increases in SSI and AMR rates. Implementation of the safe surgery checklist needs to be scaled up to support SSI prevention and control programs.

Research on the factors that influence patients with colorectal cancer participating in the prevention and control of surgical site infection: Based on the extended theory of planned behaviour.

BackgroundThe most common and severe type of nosocomial infection in patients with colorectal cancer is surgical site infection (SSI). Patient‐related factors are an important components of SSI. So it is necessary to participate in SSI prevention and control. It is important to identify the factors that influence patients' participation behaviour and to explore the mechanism of these effects.MethodsA total of 580 patients with colorectal cancer completed relevant measures. Based on the extended theory of planned behaviour, a structural equation model was used to analyse the relationship among the influencing factors.ResultsThe factors influencing participation of patients with colorectal cancer in SSI prevention and control were participation intention, participation ability, self‐efficacy, participation attitude, perceived medical staff support, trust in physicians and social support. The direct effect coefficients of participation intention, participation ability and physician trust on SSI prevention and control behaviour were 0.67, 0.21 and 0.11, respectively. Self‐efficacy, participation attitude, perceived medical staff support and social support indirectly affect participation behaviour through participation intention, and their effect values are 0.21, 0.11, 0.11 and 0.08, respectively.ConclusionsBased on the structural equation model developed in this study, targeted intervention measures should be implemented to mobilize the intention and enthusiasm of patients with colorectal cancer to participate in the prevention and control of SSI.Patient or Public ContributionPatients or public contribute to spreading research findings, and promote broad participation in the implementation of policies or strategies.

Is Single-Dose Antimicrobial Prophylaxis Sufficient to Control Infections in Gastrointestinal Oncological Surgeries?

Surgical site infections (SSIs) represent one of the most important complications occurring postoperatively following surgical procedures. The SSI incidence is higher following gastrointestinal (GI) surgeries compared to any other surgery. It contributes to the majority of morbidity and mortality in patients undergoing GI surgeries. The accepted practice worldwide for the prevention and control of SSIs is providing antimicrobial prophylaxis. The appropriate antimicrobial and dose are chosen depending on the microbial flora, complications, and patient risk factors. The objective of this review was to determine the sufficient number of prophylactic antimicrobial doses that would be efficacious and safe in controlling the SSIs following GI oncological surgeries. Single-dose antimicrobial prophylaxis has shown the same efficacy as the multiple-dose antimicrobial regimen in controlling SSIs in esophageal, gastric, and colorectal surgeries. The advantages of a single-dose regimen include less chance of emergence of resistance, less chance for allergies or toxicity, and less cost. The addition of metronidazole with single-dose antimicrobial prophylaxis in colorectal surgery should be considered due to its beneficial effect in further reducing infections. Further randomized controlled trials are needed for the literature to determine the efficacy and safety of single-dose antimicrobial prophylaxis in patients undergoing esophageal and colorectal surgeries. In addition, studies are required to determine the individual effectiveness of metronidazole in controlling SSIs in colorectal surgeries.

COMPLIANCE OF SURGICAL HAND SCRUB IN OPERATION THEATRE OF TEACHING HOSPITAL, CHITWAN

Background: Surgical hand scrub is an important practice that forms the base in the prevention and control of surgical site infection. The objective of the study was to evaluate the compliance of surgical hand scrub among surgical team in Operation Theatre of Teaching Hospital, Chitwan.
 Methods: Descriptive cross-sectional design was used. Data collection instrument (a checklist) was developed based on national and interna­tional standards of surgical hand scrub. Data was collected by observation of surgical team who were scrubbing in the Operation Theatre, Chitwan Medical College before proceeding to surgical procedures.
 Results: A compliance with the standards for surgical scrub prerequisites (70%), scrub process (81.53%), time of scrub (27%) and overall compli­ance (75.95%) observed. The total score of compliance with the standard was only 13%. The main issues found in the study were not correctly wore surgical cap and mask (44.9%), using of timer/wall clock before starting scrubbing (91.3%), improper follow the continue rotational action down opposing arms working to the elbow for one minute (53.6%) and repeat­ed blotted dry of skin area once it done (30.4%)
 Conclusions: The results showed there was gap in the surgical hand scrub of the studied hospital and the compliance with the standard can be im­proved by simple surgical hand scrub intervention, periodical observation audit and feedback.

Multimodal strategy in surgical site infections control and prevention in orthopaedic patients \u2013 a 10-year retrospective observational study at a Polish hospital

IntroductionSurgical site infections (SSIs) are among the most common healthcare-associated infections. They are associated with longer post-operative hospital stays, additional surgical procedures, risk of treatment in intensive care units and higher mortality.Material and methodsSSIs were detected in patients hospitalized in a 40-bed orthopaedics ward in 2009–2018. The total number of study patients was 15,678. The results were divided into two 5-year periods before and after the introduction of the SSI prevention plan. The study was conducted as part of a national Healthcare-Associated Infections Surveillance Programme, following the methodology recommended by the HAI-Net, European Centre for Disease Prevention and Control Program (ECDC).ResultsOne hundred sixty eight SSIs were detected in total, including 163 deep SSIs (SSI-D). The total SSI incidence rate was 1.1%, but in hip prosthesis: 1.2%, in knee prosthesis: 1.3%, for open reduction of fracture (FX): 1.3%, for close reduction of fracture (CR): 1.5, and 0.8% for other procedures. 64% of SSI-D cases required rehospitalisation. A significantly reduction in incidence was found only after fracture reductions: FX and CR, respectively 2.1% vs. 0.7% (OR 3.1 95%CI 1.4–6.6, p < 0.01) and 2.1 vs. 0.8% (OR 2.4 95%CI 1.0–5.9, p < 0.05). SSI-Ds were usually caused by Gram-positive cocci, specially Staphylococcus aureus, 74 (45.7%); Enterobacteriaceae bacillis accounted for 14.1% and Gram-negative non-fermenting rods for 8.5%.ConclusionsThe implemented SSI prevention plan demonstrated a significant decrease from 2.1 to 0.7% in SSI-D incidence only in fracture reductions, without changes in epidemiology SSI incidence rates in other procedures. Depending on the epidemiological situation in the ward, it is worthwhile to surveillance of SSIs associated to different types of orthopaedic surgery to assess the risks of SSI and take preventive measures.

Compliance of surgical hand scrub in operation theatre of teaching hospital, Chitwan

Background: Surgical hand scrub is an important practice that forms the base in the prevention and control of surgical site infection. The objective of the study was to evaluate the compliance of surgical hand scrub among surgical team in Operation Theatre of Teaching Hospital, Chitwan. &#x0D; Methods: Descriptive cross-sectional design was used. Data collection instrument (a checklist) was developed based on national and interna­tional standards of surgical hand scrub. Data was collected by observation of surgical team who were scrubbing in the Operation Theatre, Chitwan Medical College before proceeding to surgical procedures. &#x0D; Results: A compliance with the standards for surgical scrub prerequisites (70%), scrub process (81.53%), time of scrub (27%) and overall compli­ance (75.95%) observed. The total score of compliance with the standard was only 13%. The main issues found in the study were not correctly wore surgical cap and mask (44.9%), using of timer/wall clock before starting scrubbing (91.3%), improper follow the continue rotational action down opposing arms working to the elbow for one minute (53.6%) and repeat­ed blotted dry of skin area once it done (30.4%) &#x0D; Conclusions: The results showed there was gap in the surgical hand scrub of the studied hospital and the compliance with the standard can be im­proved by simple surgical hand scrub intervention, periodical observation audit and feedback.

Extended application of statistical process control-quantitative risk assessment techniques to monitor surgical site infection rates

Surgical wound infections are major challenges affecting the health and even the life of patients subjected to invasive operations in hospitals. Healthcare providers should ensure the appropriate quality control of surgical site infection (SSI). World Health Organization (WHO) provides a comprehensive global database record of SSI. Monitoring of the trend of SSI rate and magnitude using statistical process control (SPC) tools would deliver useful information about the previous, current, and expected behavior and pattern of the inspected quality characteristic. The degree of compliance with good practices guidelines and rules (GXP) and the improvement achieved or required might be assessed and quantified using Shewhart or process-behavior trending charts. The following study demonstrates the application of SPC analysis using commercial software packages in the assessment of SSI in selected cases of countries from the WHO dataset.

Factors hindering the implementation of surgical site infection control guidelines in the operating rooms of low-income countries: a mixed-method study.

The study aims to find the factors hindering the implementation of surgical site infection control guidelines in the operating rooms of low-income countries. The design of the study is a mixed-method sequential explanatory study. The setting is Shifa International Hospital and Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Participants are health care workers. A questionnaire and structured key informant interviews probed the perspectives and perceptions of different stakeholders regarding the factors which hinder the implementation of surgical site infection control guidelines. Two-hundred fifty-two health care workers took part in the survey. The response rate was 90%. The majority of the participants was based in private teaching hospitals (63.9%) and 36.1% in the public sector teaching hospitals. The factors of surveillance, knowledge, education, and culture had low scores. Qualitative data analysis revealed the hindering factors in the implementation of surgical site infection control guidelines in the operating rooms of low-income country. The important one are lack of a surveillance system, education, and culture of infection control. This study identified hindering factors regarding implementation of surgical site infection control guidelines in the operating rooms at the institutional and individual level involved in patient care. The identification of these hindering factors may help politicians, policy makers, and institutions to identify the strategies for overcoming these hindering factors. Education is the key factor for success. By offering training to health care workers, we significantly contribute to decrease the incidence of SSIs in the low-income country.

Impact of the Antibiotic Stewardship Program on Prevention and Control of Surgical Site Infection during Peri-Operative Clean Surgery.

Surgical site infections (SSIs) are the leading cause of hospital-acquired infections and are associated with substantial healthcare costs, with increased morbidity and mortality. To investigate the effects of the antibiotic stewardship program on prevention and control of SSI during clean surgery, we investigated this situation in our institution. We performed a quasi-experimental study to compare the effect before and after the antibiotic stewardship program intervention. During the pre-intervention stage (January 1, 2010 through December 31, 2011), comprehensive surveillance was performed to determine the SSI baseline data. In the second stage (January 1, 2012 through December 31, 2016), an infectious diseases physician and an infection control practitioner identified the surgical patients daily and followed up on the duration of antimicrobial prophylaxis. From January 1, 2010 to December 31, 2016, 41,426 patients underwent clean surgeries in a grade III, class A hospital. The rate of prophylactic antibiotic use in the 41,426 clean surgeries was reduced from 82.9% to 28.0% after the interventions. The rate of antibiotic agents administered within 120 minutes of the first incision increased from 20.8% to 85.1%. The rate at which prophylactic antimicrobial agents were discontinued in the first 24 hours after surgery increased from 22.1% to 60.4%. Appropriate antibiotic selection increased from 37.0% to 93.6%. Prophylactic antibiotic re-dosing increased from 3.8% to 64.8%. The SSI rate decreased from 0.7% to 0.5% (p < 0.05). The pathogen detection rate increased from 16.7% up to 41.8% after intervention. The intensity of antibiotic consumption reduced from 74.9 defined daily doses (DDDs) per 100 bed-days to 34.2 DDDs per 100 bed-days after the interventions. Long-term and continuous antibiotic stewardship programs have important effects on the prevention and control of SSI during clean surgery.

Abstract: Elective, Outpatients Immediate Breast Reconstruction: A Single-Centre Retrospective and Systematic Literature Review

INTRODUCTION: The United Kingdom’s landmark audit (January 2008 – March 2009) of its breast reconstructive practice reported on 15,479 mastectomy patients, with a 21% (3,216) immediate reconstruction rate (IBR) and network variance of 9 – 43% (p<0.001) 1. This 4-fold difference is replicated in other national studies and appears not to be determined by patients’ underlying oncology, but by multi-disciplinary network access variables. Ambulatory care (same-day discharge) has become normative for the majority of index breast procedures, driven by convenience, cost benefit,2 improved efficiencies and the aggregation of evolved techniques such as anatomical flap dissection, dual probe sentinel node staging, multimodal pain management, surgical site infection control bundles, integrated discharge planning3 and validated outcome datasets.4 This report aims to demonstrate proof of principle, by utilising ambulatory care protocols to leverage IBR access. We systematically review the evidence for ambulatory immediate breast reconstruction to date; and report on a single unit’s clinical experience over six months (April – September 2016). METHODS: A systematic (PRISMA) review was undertaken in January 2017. Search keywords included ‘breast reconstruction’, ‘mammaplasty’, ‘ambulatory surgery’ and ‘enhanced recovery after surgery’. We queried Medline (Ovid), Embase, NHS IC audits for clinical studies (2005- 2016) with no language or sample- size restrictions. Our IBR practice includes: 24- hour discharge monitoring by nurse- led practitioners; Novel, ambulatory IBR was grafted onto the existing pathway in discussion with suitable patients. We describe the cohorts’ demographics oncology dataset, perioperative times and outcomes. RESULTS: There are no reported studies evaluating ambulatory, immediate breast reconstruction. Between April and September 2016, three patients underwent ambulatory implant-based IBR. They were selected ‘organically’ with normative peri-operative screening and outcomes. They all underwent skin sparing mastectomies with implant/ADM (Surgimend PRS) IBR: mean operative time of 2 hours, 35mins; mean time to discharge 4 hours and 27mins; and 6 months follow-up with no unplanned readmissions and a normative postoperative recovery pathway. CONCLUSION: There is no reported evidence for ambulatory IBR we are aware of. Utilising our existing ambulatory care pathway, outpatient elective IBR is feasible. A prospective outcomes study5 with validated patient reported instruments would be a way to offer enhanced access to IBR in suitable patients. Reference Citations: 1. NMBR 2010 - www.hrbchdr.com/sites/default/files/MBRAuditThirdAnnualReport2010.pdf 2. Goldfarb CA et al. J Am Acad Orthop Surg 2017; 25: 12–22. Ambulatory surgical centres: A review of complications and adverse events 3. Mathis MR et al Anaesthesiology 2013; 119(6):1310- 1321. Patient selection for day case - eligible surgery: Identifying those at high risk for major complications 4. Marla S et al Int J of Surg 2009; 7: 318- 323. Systematic review of day surgery for breast cancer. 5. Bundred N et al BMJ 1998; 317: 1275- 9. Randomised controlled trial of effects of early discharge after surgery for breast cancer.

Ações no controle das infecções do sítio cirúrgico em neurocirurgia: revisão integrativa

Aim: to identify the knowledge produced and published regarding the most relevant actions in the control of surgical site infections (SSI) in neurosurgery amenable to intervention. Method: integrative review of articles published in Portuguese, English and Spanish in MEDLINE, CINAHL, LILACS, through the VHL, CAPES and PUBMED portals. Results: 23 publications were selected and analyzed, grouped into categories focusing on actions taken before, during and after surgery and surgical surveillance. Discussion: the non-operation of trichotomy, correct antibiotic prophylaxis, rigid aseptic technique in surgery, care with ventricular derivations, curative and postoperative surgical surveillance were considered relevant in the control of SSI in neurosurgery in the studies found. Conclusion: The evidence found will help to direct the actions of HICC nurses in the control of SSI in neurosurgery.

Role of Single Dose Preoperative Ceftriaxone in the Control of Surgical Site Infection in a Tertiary Level Hospital

Post-surgical wou infection is a crucial factor in surgical practice. Prolong use of postoperative antibiotic is common practice in our surgical world. This causes financial burden to our patients a antibiotic resistance. But international journals a literatures suggest using antibiotics as prophylaxis only at the time of operation a no further postoperative antibiotic is needed in clean contaminated surgery. This comparative cross-sectional study was done at the department of surgery, Sylhet MAG Osmani Medical College Hospital from 1st July 2007 to 30th June 2008. A total number of 100 patients of clean-contaminated elective laparotomy were selected. Patients were ra omly divided into two groups, in Group-I (got single dose preoperative Inj. Ceftriaxone) a in group-II (got single dose preoperative Inj. Ceftriaxone followed by Inj. Ceftriaxone for 2 days a then Cap. Cefxime for next 5 days). There is no statistically significant difference in outcome between two groups. So, single dose preoperative Inj. Ceftriaxone (1gm) is sufficient as a prophylaxis of surgical site infection in clean-contaminated elective surgery.Faridpur Med. Coll. J. Jan 2016;11(1): 6-10

Analysis of Malpractice Claims Associated with Surgical Site Infection in the Field of Plastic Surgery.

Postoperative infections are rare after plastic surgery; however, when present, they can affect the aesthetic outcome. Currently, many malpractice lawsuits are associated with surgical site infection. The present study aimed to analyze malpractice claims associated with surgical site infection in the field of plastic surgery through a review of Korean precedents. We analyzed the type of procedure, associated complications, and legal judgment in these cases. Most claimants were women, and claims were most often related to breast surgery. The common complications related to surgical site infection were deformity, scar, and asymmetry. Among the 40 cases, 34 were won by the plaintiff, and the mean claim settlement was 2,832,654 KRW (USD 2,636.6). The reasons for these judgements were as follows: 1) immediate bacterial culture tests were not performed and appropriate antibiotics were not used; 2) patients were not transferred to a high-level hospital or the infection control department was not consulted; 3) surgical site infection control measures were not appropriate; and 4) surgical procedures were performed without preoperative explanation about surgical site infection. The number of claims owing to surgical site infection after surgery is increasing. Infection handling was one of the key factors that influenced the judgement, and preoperative explanation about the possibility of infection is important. The findings will help surgeons achieve high patient satisfaction and reduce liability concerns.

Updated Recommendations for Control of Surgical Site Infections

Updated Recommendations for Control of Surgical Site Infections

Cost-benefit analysis of craniocerebral surgical site infection control in tertiary hospitals in China.

Surgical site infection (SSI) is one of the most common postoperative complications. This study aimed to determine the cost of SSIs and to evaluate whether SSI control can reduce medical costs under the current medical payment system and wage rates in China. Prospective surveillance of craniocerebral surgery was conducted between July 2009 and June 2012. SSI patients and non-SSI patients were matched with a ratio of 1:2. Terms such as medical costs and length of hospital stay were compared between the two groups. Based on the economic loss of hospital infection, which causes additional expenditures and a reduction in the number of patients treated, the benefits of hospital infection control were estimated. The costs of human resources and materials of hospital infection surveillance and control were also estimated. Finally, the cost-benefit rates in different medical contexts and with different SSI-case ratios were calculated. The incidence of SSIs in this study was 4%. SSIs significantly prolonged hospital stay by 11.75 days (95% CI: 6.24-22.52), increased medical costs by US $3,412.48 (95% CI: $1,680.65-$5,879.89). The direct economic loss was $114,903 in a 40-bed ward. The cost of implementing infection control in such a unit was calculated to be approximately $5,555.47 CONCLUSIONS: Under the current fee-for-service healthcare model in China, the control of SSIs can hardly yield direct economic benefits, but can yield social benefits. With the implementation of a total medical cost pre-payment system, SSI control will present a remarkable benefit-cost ratio for hospitals.

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

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.