Epidemiological surveillance of surgical site infections in large joint replacement

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Abstract

Joint replacement is a reliable and effective surgery that allows profound pain relief and restores joint function in patients. Despite the progress made and the experience gained in joint replacement, surgical site infection is one of the leading postoperative complications. It can proceed as a periprosthetic joint infection, osteomyelitis, sepsis and lead to disabled or dead outcomes. Systematization of risk factors for infectious complications plays an important role as an element of epidemiological surveillance system optimization. Age, the presence of concomitant diseases (for example, diabetes mellitus, cancer, arthritis and systemic collagenosis), carriage of antimicrobial-resistant microorganisms, infectious and inflammation both outside and in the area of surgery, and external factors (surgery duration, correct antibiotic prophylaxis and surgeon's experience) are the most significant risk factors for periprosthetic joint infection. In world practice, the National Nosocomial Infections Surveillance System surgical site infection risk index is used. This criterion does not consider all potential risk factors. It is important to analyze and rank the identified risk factors according to the impact on the development of infectious complications in organizing an epidemiological surveillance system process in a medical organization. Risk factors analysis will identify the most significant modifiable factors for the development, implementation and execution of organizational, preventive measures and epidemic control. The creation and implementation of a standardized preoperative protocol based on a risk factors assessment will allow predicting the surgery outcome and arguing the strategy and tactic of preventive measures.

About the authors

Irina A. Bulycheva

Kazan State Medical University; City Polyclinic No. 21

Author for correspondence.
Email: Irishe4ka_94@mail.ru
ORCID iD: 0000-0001-7289-3037
SPIN-code: 5183-5140

Assistant, Depart. of Epidemiology and Evidence-based Medicine; Epidemiologist, Kazan Outpatient Clinic No. 21

Russian Federation, Kazan, Russia; Kazan, Russia;

Ksenija A. Kondratieva

Kazan State Medical University

Email: kseenia97@mail.ru
ORCID iD: 0000-0002-3004-0412

Resident, Depart. of Hospital Pediatrics

Russian Federation, Kazan, Russia

Gulnara R. Yakupova

Kazan State Medical University

Email: gulnarochka_97@mail.ru
ORCID iD: 0000-0003-2217-7352

Resident, Depart. of Preventive Medicine

Russian Federation, Kazan, Russia

Alla I. Lokotkova

Kazan State Medical University

Email: Allalok12@mail.ru
ORCID iD: 0000-0003-4482-6050
SPIN-code: 5262-1969

Cand. Sci. (Med.), Assoc. Prof., Depart. of Epidemiology and Evidence-based Medicine

Russian Federation, Kazan, Russia

Eldar Kh. Mamkeev

Kazan State Medical Academy — Branch Campus of Russian Medical Academy of Continuous Professional Education

Email: mamkeevv@mail.ru
ORCID iD: 0000-0002-3781-8629

Cand. Sci. (Med.), Assoc. Prof., Depart. of Epidemiology and Disinfectology

Russian Federation, Kazan, Russia

Marat R. Mazitov

Kazan State Medical University; City Polyclinic No. 21

Email: marat.mazitov@tatar.ru
ORCID iD: 0000-0002-2462-3005

Assistant, Depart. of General Hygiene; Deputy Chief Physician for Medical Affairs

Russian Federation, Kazan, Russia; Kazan, Russia

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