[Etiology of surgical site infections in orthopedic surgery after multiple injuries]

Surgical site infection is one of the most severe complications in patients with multiple injuries. It causes elongation of hospitalization time, greatly increases costs of treatment and may directly endanger patient's life. The aim of the study was to analyze bacterial flora causing surgical site infections in group of patients with multiple injuries.

A retrospective analysis was conducted on medical history of 31 patients with multiple injuries, who in years 2011-2012 due to surgical site infections required further treatment in Department of Musculoskeletal System Infections.

In analyzed material majority of infections were caused by multiple bacteria species--18 (58%). Throughout the isolated flora the most frequent were gram-negative bacteria, especially A. baumanii--16 (29.6%) and P. areuginosa--5 (9.3%). Participation of gram-positive flora which until now was dominating as a cause of musculoskeletal system infections, has significantly decreased. Additionally, in this group we can see dominance of bacteria from Enterococcus genus--E. fecalis--10 (18.5%), and not as it used to be from Staphylococcus--S. aureus--6 (11%), S. epidermidis--3 (5.6%).

The most common were acute infections caused by multiple bacteria species with dominance of gram-negative flora. Very interesting is the fact of fall of infection rate caused by Staphylococci. Monitoring of bacterial etiological factors has a key role in proper antibiotic administration, with is essential in successful surgical treatment.