Surgical Infections and Hand Hygiene in a Surgical Ward

The purpose of the study is to compare the community-acquired surgical infections with nosocomial infections caused by germs that are transmitted through the hands, in the General Surgery Department of the Baia Mare Emergency County Hospital, Romania. Materials and methods. There were selected all positive cultures with germs that are circulated through poor hygiene of hands from patients hospitalized during 2017. Samples were taken from surgical wound, peritoneal fluid, sputum, urine, stool, blood cultures and tegument. From the patient's electronic records were recorded: age, gender, DRG disease code (ICD 10), type of wound, administered antibiotics, postoperative progression, length of hospitalization and cost of day of hospitalization. Results. There were 201 (5.61%) patients with community-acquired infections and 71 (1.98%) with nosocomial infections with Staphylococcus aureus MSSA and MRSA, Enterococcus, Klebsiella pneumoniae, Enterobacter, Pseudomonas aeroginosa, Candida, Clostridium difficile and Streptococcus pyogenes. Community-acquired Staphylococcus aureus MRSA strains were more common in women, and the nosocomial ones in males. The most common deaths were caused by nosocomial infections with Candida (0.001), Klebsiella pneumoniae (p = 0.026) and Enterococcus (p = 0.001), and the highest cost / day of hospitalization was recorded in nosocomial infections with Staphylococcus aureus MRSA (p = 0.045), Enterococcus (p = 0.001) and Candida (p = 0.001). It was found resistance to betalactamic and vancomycin in the nosocomial strains of Staphylococcus aureus MRSA. Conclusions. Nosocomial infections with hands transmitted germs cause the worst surgical infections compared to community-acquired infections produced by the same types of germs