INTRODUCTION Surgical 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 METHODS SSIs 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). RESULTS One 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%. CONCLUSIONS The 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.

中文翻译：

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骨科患者手术部位感染控制和预防的多模式策略-在波兰一家医院进行的为期10年的回顾性观察研究。

引言手术部位感染（SSI）是最常见的医疗保健相关感染。它们与术后更长的住院时间，更多的外科手术程序，重症监护病房的治疗风险以及更高的死亡率有关。材料与方法在2009-2018年期间，在40张病床的骨科病房住院的患者中检测到SSI。研究的患者总数为15678。在实施SSI预防计划之前和之后，结果分为两个5年期。该研究是根据HAI-Net欧洲疾病预防控制中心（ECDC）推荐的方法，作为国家医疗保健相关感染监测计划的一部分进行的。结果共检测到168个SSI，包括163个深SSI（SSI-D）。SSI的总发生率为1.1％，但在髋关节假体中：1.2％，在膝关节假体中：1.3％，对于开放性骨折复位（FX）：1.3％，对于闭合性骨折复位（CR）：1.5和0.8％其他程序。SSI-D病例中有64％需要重新住院。仅在骨折复位后才发现发病率显着降低：FX和CR分别为2.1％vs. 0.7％（OR 3.1 95％CI 1.4-6.6，p <0.01）和2.1 vs. 0.8％（OR 2.4 95％CI 1.0 -5.9，p <0.05）。SSI-Ds通常是由革兰氏阳性球菌引起的，特别是金黄色葡萄球菌74（45.7％）。肠杆菌科细菌占14.1％，革兰阴性非发酵棒占8.5％。结论实施的SSI预防计划表明，仅在骨折复位方面，SSI-D发生率从2.1％显着降低至0.7％，其他程序中没有改变流行病学SSI发生率。根据病区的流行病学情况，有必要对与不同类型的骨科手术相关的SSI进行监测，以评估SSI的风险并采取预防措施。