{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:03:38Z","timestamp":1783465418970,"version":"3.55.0"},"reference-count":18,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T00:00:00Z","timestamp":1653004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Surgical site infections (SSIs) are the most common healthcare-associated infections (HAIs) in surgical wards. The highest risk of developing SSI is carried by operations involving implants, such as: hip prosthesis (HPRO), knee prosthesis (KPRO), open reduction of fracture (FX), and closed reduction of fracture with internal fixation (CR). Objectives. The objective of the study was to assess the incidence of SSI in patients subjected to HPRO, KPRO, FX, and CR procedures in orthopaedics and trauma wards in 2014\u20132018 considering risk factors included in the SIR index. Materials and Methods: The study included 6261 patients who were subjected to orthopaedic surgery in 2014\u20132018. The investigation covered three hospitals with orthopaedics and trauma wards. The research was conducted in the framework of the national HAI surveillance programme according to the methodology of the HAI-Net, ECDC. Results: A total of 6261 surgeries were investigated, of which 111 cases of SSI were detected. The incidence was 1.8%; HPRO (incidence 2.1%, median (Me) surgery duration 90 min, and standardized infection ratio (SIR) above 1 in all units tested); KPRO (incidence 2.0%, Me 103 min, and SIR above 1 for all units tested); FX (incidence 1.9%, Me 70 min, and SIR above 1 for two units tested and below 1 in one unit); CR (incidence 1.0%, Me 55 min, and SIR\u2014not calculated). The etiological agents that were most frequently isolated from patients with SSI were Staphylococcus aureus, coagulase-negative Staphylococcus, and Klebsiella pneumoniae. Conclusions: HPRO, KPRO, and FX operations performed in the studied wards carried a higher risk of developing SSI than that predicted by SIR. SSIs accounted for a significant percentage of the overall infection pool in CR surgeries. Actions should be undertaken to reduce the incidence of SSI in these surgeries. There should be a hospital network which facilitates cooperation in order to better monitor and analyse the incidence of SSI.<\/jats:p>","DOI":"10.3390\/medicina58050682","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T13:56:12Z","timestamp":1653054972000},"page":"682","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Five-Year Analysis of Surgical Site Infections in Three Orthopaedics and Trauma Wards under HAI-Net from the South of Poland in 2014\u20132018 Considering the Standardized Infection Ratio"],"prefix":"10.3390","volume":"58","author":[{"given":"Marta Zofia","family":"Wa\u0142aszek","sequence":"first","affiliation":[{"name":"State Higher Vocational School in Tarn\u00f3w, 33-100 Tarn\u00f3w, Poland"},{"name":"St. Luke\u2019s Provincial Hospital in Tarn\u00f3w, 33-100 Tarn\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ro\u017ca","family":"S\u0142owik","sequence":"additional","affiliation":[{"name":"State Higher Vocational School in Tarn\u00f3w, 33-100 Tarn\u00f3w, Poland"},{"name":"St. Luke\u2019s Provincial Hospital in Tarn\u00f3w, 33-100 Tarn\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9452-8361","authenticated-orcid":false,"given":"Adam","family":"Doma\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Distributed Systems and IT Equipment, Faculty of Automatic Control, Electronics and Computer Science, The Silesian Technical University, 44-100 Gliwice, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Micha\u0142 Jan","family":"Wa\u0142aszek","sequence":"additional","affiliation":[{"name":"Polish Society of Hospital Infections, 31-121 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"R\u00f3\u017ca\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Jagiellonian University, 31-121 Krak\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"Ko\u0142pa","sequence":"additional","affiliation":[{"name":"State Higher Vocational School in Tarn\u00f3w, 33-100 Tarn\u00f3w, Poland"},{"name":"St. Luke\u2019s Provincial Hospital in Tarn\u00f3w, 33-100 Tarn\u00f3w, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,5,20]]},"reference":[{"key":"ref_1","unstructured":"Estudio Epine-EPPS-2017 (2021, February 16). Seg\u00fan el protocolo \u201cEPINE-Point Prevalence Survey of Healthcare-Associated Infections and Antimicrobial Use in Acute Care Hospitals, ECDC 2016\u20132017\u201d. Estudio EPINE no 28: 1990\u20132017. Available online: https:\/\/www.hartmann.info\/-\/media\/riskprevention\/doc\/epine-epps_2017_informe_global_de_espana_resumen_0.pdf?la=es-es&hash=FBDBAF1176F9158F161F55C812D3B3CA32F73756."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Ko\u0142pa, M., Wa\u0142aszek, M., R\u00f3\u017ca\u0144ska, A., Wolak, Z., and W\u00f3jkowska-Mach, J. (2018). Hospital-Wide Surveillance of Healthcare-Associated Infections as a Source of Information about Specific Hospital Needs. A 5-Year Observation in a Multiprofile Provincial Hospital in the South of Poland. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15091956"},{"key":"ref_3","first-page":"165","article-title":"Information on nosocomial infections in the mainstream media: An opinion document","volume":"32","author":"Bouza","year":"2019","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"429","DOI":"10.5414\/CP203339","article-title":"Pharmacoeconomic analysis of antibiotic therapy in surgical site infections","volume":"57","author":"Paluch","year":"2019","journal-title":"Int. J. Clin. Pharmacol. Ther."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2009","DOI":"10.1007\/s00264-019-04298-x","article-title":"Can surgical site infections be controlled through microbiological surveillance? A three-year laboratory-based surveillance at an orthopaedic unit, retrospective observatory study","volume":"43","author":"Bielecki","year":"2019","journal-title":"Int. Orthop."},{"key":"ref_6","first-page":"45","article-title":"The New Zealand Surgical Site Infection Improvement (SSII) Programme: A national quality improvement programme reducing orthopaedic surgical site infections","volume":"131","author":"Morris","year":"2018","journal-title":"New Zealand Med. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1111\/iwj.13096","article-title":"Surgical site infection following elective orthopaedic surgeries in geriatric patients: Incidence and associated risk factors","volume":"16","author":"Liang","year":"2019","journal-title":"Int. Wound J."},{"key":"ref_8","unstructured":"European Centre for Disease Prevention and Control (2017). Surveillance of Surgical Site Infections and Prevention Indicators in European Hospitals-HAI-Net SSI Protocol, ECDC. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/HAI-Net-SSI-protocol-v2.2.pdf."},{"key":"ref_9","unstructured":"World Health Organization (2018). Global Guidelines for the Prevention of Surgical Site Infection, World Health Organization. [2nd ed.]. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/277399\/9789241550475-eng.pdf?sequence=1&isAllowed=y."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"S\u0142owik, R., Ko\u0142pa, M., Wa\u0142aszek, M., R\u00f3\u017ca\u0144ska, A., Jagiencarz-Starzec, B., Zie\u0144czuk, W., Kawik, \u0141., Wolak, Z., and W\u00f3jkowska-Mach, J. (2020). Epidemiology of Surgical Site Infections Considering the NHSN Standardized Infection Ratio in Hip and Knee Arthroplasties. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17093167"},{"key":"ref_11","unstructured":"European Centre for Disease Prevention and Control (2015). European Surveillance of Healthcare-Associated Infections in Intensive Care Units. HAI-Net ICU Protocol, ECDC. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/media\/en\/publications\/Publications\/healthcare-associated-infections-HAI-ICU-protocol.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/0196-6553(91)90157-8","article-title":"National nosocomial infections surveillance system (NNIS): Description of surveillance methods","volume":"19","author":"Emori","year":"1991","journal-title":"Am. J. Infect. Control"},{"key":"ref_13","unstructured":"European Union (2012). Commision Implementing Decision of 8 August 2012 Amending Decision 2002\/253\/EC Laying Down Case Definitions for Reporting Communicable Diseases to the Community Network under Decision No 2119\/98\/EC of the European Parliament and of the Council. Off. J. Eur. Union., 262, 21. Available online: https:\/\/eur-lex.europa.eu\/legalcontent\/EN\/TXT\/HTML\/?uri=CELEX:32012D0506."},{"key":"ref_14","unstructured":"European Centre for Disease Prevention and Control (2019). Healthcare-associated infections: Surgical site infections. ECDC. Annual Epidemiological Report for 2017, ECDC. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/AER_for_2017-SSI.pdf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1016\/j.ajic.2009.10.001","article-title":"National Healthcare Safety Network (NHSN) Report: Data Summary for 2006 Through 2008, Issued December 2009","volume":"37","author":"Edwards","year":"2009","journal-title":"Am. J. Infect. Control"},{"key":"ref_16","unstructured":"European Centre for Disease Prevention and Control (2018). Healthcare-associated infections: Surgical site infections. ECDC. Annual Epidemiological Report for 2016, ECDC. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/AER_for_2016-HAI_0.pdf."},{"key":"ref_17","first-page":"1","article-title":"Multimodal strategy in surgical site infections control and prevention in orthopaedic patients\u2014A 10-year retrospective observational study at a Polish hospital","volume":"9","author":"Wolak","year":"2020","journal-title":"Antimicrob. Resist. Infect. Control"},{"key":"ref_18","first-page":"439","article-title":"Surgical site infections in patients of orthopedic-trauma unit in district hospital in 2008\u20132012","volume":"67","author":"Walaszek","year":"2013","journal-title":"Przegl\u0105d Epidemiol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/682\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:15:53Z","timestamp":1760138153000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/5\/682"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,20]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2022,5]]}},"alternative-id":["medicina58050682"],"URL":"https:\/\/doi.org\/10.3390\/medicina58050682","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,20]]}}}