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Arch Hellen Med, 26(3), May-June 2009, 390-400


Risk factors for development of surgical site infections (SSIs) in a tertiary hospital in Greece

1University General Hospital of Heraklion,
2Administrative and Economic School, ATEI of Crete,
3General Secretary of Social Welfare, Ministry of Health and Social Solidarity, Athens, Greece

OBJECTIVE The identification of risk factors for surgical site infections (SSIs) and the pathogenic microorganisms responsible in a tertiary general hospital in Greece.

METHOD The study was a cohort epidemiological survey which was conducted during the period October 2005-June 2006 at a University General Hospital in Greece. A total of 911 patients were included and 945 surgical operations were conducted during the study period.

RESULTS In total, 61 infections of the surgical site were detected in the 945 operations (6.5 infections/100 operations). The location of the infections was: 19 superficial incisional (31.1%), deep incisional 23 (37.7 %) and organ space 19 (31.1%). The most common microorganisms that were detected were Enterococcus faecium (17.9%), Enterococcus faecalis (11.8%), Escherichia coli and Pseudomonas aeruginosa (14.5%). Prophylactic antibiotic treatment had been administered for 61.6% of interventions. Risk factors that were found to affect the growth of SSIs were age >60 years old, hospitalization in the intensive care unit (ICU), multiple operations, the ASA score (2, 3, 4), long duration of the operation and the classification of the surgical wound; specifically, potentially infected wound, the risk index NNISS (1, 2, 3), a preoperative duration of hospitalization of >=48 hours, and prophylactic treatment with antibiotics.

CONCLUSIONS Although the use of prophylactic antibiotics is excessively high, the surgical patients in a Greek tertiary hospital suffer from high rates of SSI. The organization and operation of an appropriate protocol, the application of an information dissemination program and the modification of the growth factors of SSIs must comprise the future axis of intervention, with the objective of prevention of infection and thus, the promotion of health and the improvement of the quality of life of the surgical patients.

Key words: Risk factors, Surgical site infection, Surveillance of SSIs.

© Archives of Hellenic Medicine