Surgical Site Infections in Orthopaedics: Epidemiology & Microbiology

Journal of Clinical Orthopaedics | Vol 4 | Issue 2 |  July-Dec 2019 | page:7-11 | Dr. Kedar Deogaonkar, Aditya Menon, Gautam Zaveri

Author: Dr. Kedar Deogaonkar [1], Aditya Menon [2], Gautam Zaveri [3]

[1] Department of Spine Surgery, Jaslok Hospital & Research Centre.

Address of Correspondence
Dr. Gautam Zaveri,
Department of Spine Surgery, Jaslok Hospital & Research Centre


Surgical site infections are one of the most common nosocomial infections. understanding epidemiology and microbiology of SSI will help in defining the problem and developing stratergies for prevention and management
Keywords: Surgical Site infection, Diagnosis.


1. Harrop JS, Styliaras JC, Ooi JC, et al. Contributing factors to surgical site infections. J AAOS. 2012; 20(2):94-101
2. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, Am J Infect Control. 2004; 32:470- 85
3. Ercole FF, Chianca TCM. Infecção de sítiocirúrgico empacientes submetidos à artroplastia de quadril. Revista Latino-Am. Enfermagem. 2002; 10(2):157-65
4. Lima ALLM, Zumiotti AV, Uip DE, Silva JS. Fatorespreditivos de infecçãoempacientes com fraturasexpostasnos membros inferiores. Acta Ortop Bras. 2004; 12(1):23-39
5. Maksimovic J. Incidence of surgical site infections in the departments of orthopedics and traumatology. Vojnosanit Pregl. 2006; 63(8):725-9
6. Maksimovic J, Markovíc-Denic L, Bumbasrevic M, et al. Surgical site infections in orthopedics patients: prospective cohort study. Croat Med J. 2008; 49(1):58-65
7. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. NEJM. 2004; 351:1645-54
8. Achermann Y, Sahin F, Schwyzer HK et al. Characteristics and outcome of 16 periprosthetic shoulder joint infections. Infection 2013; 41: 613–20
9. Corvec S, Portillo ME, Pasticci BM et al. Epidemiology and new developments in the diagnosis of prosthetic joint infection. Int J Artif Organs 2012; 35: 923 34
10. Zimmerli W, Sendi P. Pathogenesis of implant-associated infection: The role of the host. SeminImmunopathol 2011; 33: 295–306
11. accessed 21/07/19
12. Horan TC, Gaynes RP, Martone WJ, et al. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992; 13(10):606-608
13. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. NEJM 2004; 351: 1645–54
14. Centers for Diseases Control and Prevention. The National Healthcare Safety Network Manual – NHSN. Patient Safety Component Protocol. Division of Healthcare Quality Promotion National Center for Preparedness, Detection and Control of Infectious Diseases Atlanta, GA, USA, 2009, 225.
15. accessed 21/07/19
16. Jaylakhsmi T, Kapil A, Sathpathy S, et al. AIIMS hospital infection control manual: All India institute of medical sciences, 2004
17. De Man FHR, Sendi P, Zimmerli W et al. Infectiological, functional, and radiographic outcome after revision for prosthetic hip infection according to a strict algorithm. Acta Orthop 2011; 82: 27–34
18. Jamsen E, Huhtala H, Puolakka T et al. Risk factors for infection after knee arthroplasty. A register-based analysis of 43149 cases. JBJS Am 2009; 91: 38–47
19. Das R, Singh A, Srivastava P, et al. Microbial Profile and Antibiotic Susceptibility Pattern of Surgical Site Infections in Orthopaedic Patients at a Tertiary Hospital in Bilaspur. Int J Sci Stud 2015;3(3):43-47
20. Amaradeep G, Shiva Prakah SS, Manjappa CN. Surgical site infections in orthopedic implant surgery and its risk factors: A prospective study in teaching hospital. Int J of OrthopSci 2017; 3(3): 169-172
21. Maksimovic J, Markovíc-Denic L, Bumbasrevic M, et al. Surgical site infections in orthopedics patients: prospective cohort study. Croat Med J. 2008; 49(1):58-65
22. Khan MS, Rehman S, Ali MA, et al. Infection in orthopedic implant surgery, its risk factors and outcome. J Ayub Med Coll Abbottabad, 2008; 20(1):23-5
23. Wassef MA, Hussein A, Abdul Rahman EM, El-Sherif RH. A Prospective Surveillance of Surgical Site Infections: Study for Efficacy of Preoperative Antibiotics Prophylaxis. Afr. J. Microbiol. Res. 2012; 6(12):3072-8
24. Singh R. Prevalence and Antibiotic Sensitivity Pattern of Bacteria Isolated from Nosocomial Infections in Orthopaedic Patients. J. Orthopaedics. 2010; 7(2):153-159
25. Borthakur B, Kumar S, TalukdarM, et al.Surgical site infection in orthopaedics. Int. J. Orthop. Sci., 2016; 2(3): 113-117
26. Anderson DJ, Sexton DJ, Kanafani ZA, et al. Severe surgical site infection in community hospitals epidemiology, key procedures and the changing prevelance of methicillin resistant Staphyloccocus aureus. Infect control hospl epidemiol. 2007; 28(9):1047-1053
27. Koch R, Becker K, Cookson B, et al. Methicillin resistant staphylococcus aureus burden of disease and control challenges in Europe. Euro Surviell, 15(41)
28. Esterhai J, Gelb I. Orthopaedic infection. OCNA 1991; 22:503-10
29. Wertheim HF, Melles DC, Vos MC, et al. The role of nasal carriage in staphylococcus aureus infections. Lancet infect dis. 2005, 5(12)
30. Rao N, Kim DH. Perioperative risk factors and patient optimization: risk assessment and prevention. In Hsu WK, McLaren AC, Springer BD, editors. Let’s discuss Surgical Site Infection.: J AAOS, 2015, 13-23
31. Engemann JJ, Carmeli Y, Cosgrove SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with staphylococcus aureus surgical site infection. Clin Infect Dis. 2003; 36(5):592- 598
32. Perl TM, Golub JE. New approaches to reduce staphylococcal aureus nosocomial infection rates: treating S aureus nasal carriage. Ann Pharmacother. 1998; 32(1):S7-S16
33. West SK, Plantengna MS, Strausbaugh LJ. Emerging Infections network, Infectious disease society of America Use of decolonisation to prevent Staphylococcal infection in various healthcare settings: Results of an emerging infections Networks survey. Infec Control Hosp Epidemiol. 2007; 28(9):1111-1113
34. Hansen S, Schwab F, Asensio A, et al. Methicillin resistant Staphylococcus Aureus in Europe which infection control measures are taken? Infection, 2010, 38(3)
35. Berbari EF, Aea OD. Dental procedures are risk factors for prosthetic hip and knee infection. A Hospital Based Prospective Case Control Study. Clin Infect Dis. 2010, 50(1)
36. Tlaskalova-Hogenova H, Stepankova R, Hudcovic T, et al. Commensal bacteria (normal microflora), mucosal immunity and chronic inflammatory and autoimmune diseases. Immuno Lett. 2004, 93(2-3)
37. Wolcott RD, Ehrlich GD. Biofilms and chronic infections. J Am Med Assoc. 2008; 299:2682–2684
38. Ehrilch GD, Ahmed A, Earl J, et al. The distributed genome hypothesis as a rubric for understanding evolution in-situ during chronic bacterial biofilm infectious process. FEMS Immunolo Med Microbiol. 2010; 59(3):269-279
39. Costerton JW, Stewart PS, Greenberg EP. Bacterial biofilms a common cause of persistent infections. Science. 1999; 284(5418):1318-1322
40. Donlan RM, Costerton JW. Biofilms survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev. 2002; 15(2):167-193
41. McLaren AC, Shirtliff ME. Biofilms in surgical site infection. In Hsu WK, McLaren AC, Springer BD, editors. Let’s discuss Surgical Site Infection.: AAOS, 2015, 2-9
42. Costerton W, Veeh R, Shirtliff M, et al. The application of biofilm science to the study and control of chronic bacterial infections. J Clin Invest. 2003; 112(10):1466-1477
43. Wymenga AB, van Horn JR, Theeuwes A, et al. Perioperative factors associated with septic arthritis after arthroplasty. Prospective multicenter study of 362 knee and 2,651 hip opera- tions. Acta OrthopScand 1992;63(6):665–671
44. Bozic KJ, Ward DT, Lau EC, et al. Risk factors for periprosthetic joint infection following primary total hip arthroplasty: a case control study. J Arthroplasty 2014;29(1):154–156
45. Workgroup of the American Association of Hip and Knee Surgeons Evidence Based Committee. Obesity and total joint arthroplasty: a literature based review. J Arthroplasty 2013 28(5):714–21.
46. Bozic KJ, Lau E, Ong K, et al. Risk factors for early revision after primary TKA in medicare patients. CORR 2014;472(2):449–454.
47. Berbari EF, Hanssen AD, Duffy MC, et al. Risk factors for prosthetic joint infection: case- control study. Clin Infect Dis 1998;27(5):1247–1254.

How to Cite this article: Deogaonkar K, Menon A, Zaveri G. Surgical Site Infections in Orthopaedics: Epidemiology & Microbiology. Journal of Clinical Orthopaedics July-Dec 2019;4(2):7-11.

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