title: A Retrospective Analysis of Bacteriological Studies of Surgical Site Infections in a Monoprofile, Multidepartmental Orthopedic Hospital.
abstract: BACKGROUND
  Despite improvements in surgical techniques, aseptics and prevention of infections, hospital surgical site infections (SSI) still remain one of the main reasons for failure in therapeutic musculoskeletal surgery. This study aimed to conduct a retrospective analysis of microbiological examinations and determine pathogen sensitivity to antibiotics as the basis for selecting methods for preventing and treating complicating infections.
  
  
  METHODS
  The study is a retrospective analysis of bacteriological tests performed in the departments of the Public Clinical Hospital of the Medical Centre of Postgraduate Education in Otwock. Importantly, our monoprofile hospital specialising in musculoskeletal pathology is a reference centre, admitting patients from the entire country. Often these are patients transferred from Intensive Care Units at other hospitals with internally infected local emergencies (infections with local, complex, multidrug resistant bacterial flora). Bacteriological mapping of the hospital covered the period from 2009 to 2013 to indicate so called "strategic departments" demonstrating the most complex multidrug-resistant bacterial flora. Surgical site infections were managed by surgery with targeted antibiotic therapy.
  
  
  RESULTS
  Analysis of patients' profiles revealed that SSIs detected across hospital departments in SPSK CMKP in Otwock mostly came from other medical centers where patients were initially hospitalized. The Osteomyelitis Department and the Department of Pelvic Pathology and Traumatology were identified as "strategic departments".
  
  
  CONCLUSIONS
  1. The analysis indicated that methicillin-sensitive Staphylococcus aureus (MSSA) was the most common pathogen responsible for complicating infections in our hospital. 2. The percentage of bacterial resistance to methicillin signifi -cantly increased in patients with multi-organ injuries who had previously been hospitalized at other centres. 3. Credible prevention and diagnosis of inflammatory risk factors in the preoperative period was of key importance in reducing the percentage of complicating infections.
authors.affiliation: Orthopedics Department, Prof. Adam Gruca Public Teaching Hospital, Postgraduate Medical Education Centre, Otwock, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Grajek
authors.affiliation: Orthopedics Department, Prof. Adam Gruca Public Teaching Hospital, Postgraduate Medical Education Centre, Otwock, Poland.
authors.forename: Jerzy
authors.initials: J
authors.lastname: Białecki
authors.affiliation: Orthopedics Department, Prof. Adam Gruca Public Teaching Hospital, Postgraduate Medical Education Centre, Otwock, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Marczyński
authors.affiliation: Orthopedics Department, Prof. Adam Gruca Public Teaching Hospital, Postgraduate Medical Education Centre, Otwock, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Walczak
authors.affiliation: Orthopedics Department, Prof. Adam Gruca Public Teaching Hospital, Postgraduate Medical Education Centre, Otwock, Poland.
authors.forename: Julia
authors.initials: J
authors.lastname: Macias
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009141:Musculoskeletal System / Q000382:microbiology* / Q000601:surgery*; D011044:Poland; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000453:epidemiology; D013211:Staphylococcus aureus / Q000187:drug effects*; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents