Evaluation of factors influencing the surgical site infections in health care institution

The aim of the study – to evaluate the factors influencing the development of patients surgical site infections in health care insitution. The methods and materials The study object – patients with surgical site infection (SSI) after abdominal surgery in X hospital. Sample of study consisted of 22 patients (10 men and 12 women), aged 20-75 years. Data about the patients’ age, obesity and diabetes were collected from medical records. To assess the prevalence of microbes in environment, 50 samples were collected from different surfaces (beds, cabinets, medical equipment, etc.). Material for bacteriological examination was collected into the transport medium and sown in petri plates with blood agar and selective culture medium. The sensitivity for antimicrobial materials of isolated microorganisms (Staphylococci, Pseudomona aeruginosa, Enterobacteriaceae and E. coli) was estimated using the modified Kirby - Bauer method. Research results The analysis of 22 medical records showed that emergency surgical operations were performed for 13 patients and scheduled operations – for 9 patients. It was found that SSI developed after intestinal surgery (50.0 %) more often. SSI developed in patients, aged 75 or older, compared to 20 – 44 years old patients. Study results showed that contiguous deseases (obesity and diabetes) had no influence on SSI development. After analysis of 22 patients microbiological tests, 32 microbes were determined. P. aeruginosa was isolated more often (25.0 %), although their prevalence did not differ from other microbes. 50 bacteriological tests from environmental surfaces (procedural tables, medical equipment, etc.) were collected: microorganisms were less found on the beds and cabinets compared to procedural tables and medical equipments. The most common microflora was coagulase-negative staphylococci (54.2 %). Isolated staphylococci were resistant to penicillin (92.3 %), ampicillin (69.2 %) amoxicillin with clavulanic acid, cefoxitin, gentamicin, tetracycline, trimethoprim with sulfametoksazolum (53.8 %). E. coli was 100 % resistant for ampicillin, amoxicillin with clavulanic acid and cefalexin, but 100 % sensitive to ciprofloxacin. Enterobacteriaceae were 100 % resistant for such antimicrobial materials as ampicillin, amoxicillin with clavulanic acid and ciprofloxacin, but 100 % sensitive for gentamicin, trimethoprim with sulfametoksazolum and cefalexin. P. aeruginosa was resistant (100 %) to amoxicillin with clavulanic acid and cefalexin, gentamicin and ciprofloxacin (60 %), but sensitive to polymyxin (100 %) only. Conclusions 1. The highest risk of surgical site infections was observed for the patients aged 75 years or older (p 0.05). 2. In the study, 32 microorganisms causing surgical site infections were found. The most of them were gram-negative pathogens (p 0.05)