Evaluation of surgical site infections and determination of risk factors in Gaziantep University Medicine Faculty Hospital

Surgical site infection (SSI) are most important operative complications. It causes serious mortality, morbidity and socioeconomic losses. SSI occurs in approximately 2-5% of surgical procedures and makes up approximately ¼ of all nosocomial infections. Numerous patient-related and procedure-related factors influence the risk of SSI. This study was conducted with the aim of exploring infection rate, infectious agents, antibiotic susceptibilities of etiological agents and risk factors for the development of infection in surgical units of our hospital.Between 17th March 2008 and 15th July 2008, all patients (1397) who underwent surgical interventions and stayed over 48 hours in the other surgical units except Ophthalmology unit of Gaziantep University Medical Faculty were included in the study. The `Centers for Disease Control and Prevention? (CDC) criteria were used for identifying and diagnosing SSI. SSI rate was calculated as the number of SSI developing after every 100 surgical procedures. Potential risk factors for SSI were evaluated by multivariate logistic regression model.SSI occurred in 131 (9.4%) of 1397 patients during this period. SSI extended length of stay by 12.8 days. The highest SSI incidence rates were observed in colon surgery (27.1%). Gram negative microorganisms accounted for 74.6% of SSI isolates. The most frequently isolated microorganism was Escherichia coli (32.8%). In multivariate logistic regression analysis, diabetes mellitus (OR:2.660, CI:1.389-5.093), use of surgical drain (OR:3.706, CI:1.910-7.191), perioperative transfusion (OR:1.787, CI:1.077-2.965), trauma (OR:2.244, CI:1032-4.880), reoperation (OR:7.408, CI:3.315-16.555), wound classes of contamineted (OR:3.291, CI:1.433-7.556) or dirty-infected (OR:3.451, CI:1.888-6.310) and each point increase in National Nosocomial Infection Surveillance (NNIS) risk index (OR:7.499, CI:4.336-12.967) were detected as independent risk factors for developing SSI.In order to decrease SSI rate, risk factors should be determined and essential measures should be taken for preventable factors. In this context, the excess blood transfusion and unnecessary use of surgical drains should be avoided, surgical drains should be pulled out as soon as possible. In addition, traditional wound classification and NNIS risk index may be used in predicting SSI.Key words: Surgical site infection, causative microorganisms, risk factors