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2026-06

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cc-by-nc-nd (c) Zules Oña, Ricardo et al., 2026
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/230305

Risk factors of surgical site infection in total knee arthroplasty: Impact of an infection prevention and control intervention in a tertiary hospital in Barcelona, Spain

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https://doi.org/10.1016/j.ajic.2025.12.016

Resum

Background: In early 2018, we detected an increase in surgical site infections (SSI) after total knee arthroplasty in a tertiary hospital in Barcelona. We implemented an infection prevention and control (IPC) intervention reinforcing preventive bundles and reorganizing surgical schedules for high-risk patients and senior surgeons. We aimed to identify SSI-associated factors and evaluate the IPC intervention's impact. Methods: We conducted a retrospective cohort study in 2018 with 90-day follow-up. SSI rates were compared pre- and post-intervention. Preintervention risk factors were assessed using Cox models. Differences in associated factor distributions were estimated. Kaplan-Meier and log-rank tests evaluated incidence, and a sensitivity analysis was stratified by American Society of Anesthesiologists (ASA) and National Nosocomial Infection Surveillance (NNIS) risk. Results: Among 463 patients, overall SSI incidence was 0.52 per 1,000 patient-days. Incidence significantly declined postintervention (pre: 0.75; post: 0.26; P = .030). Obesity (HR: 3.63; 95% CI: 1.02-12.86) and afternoon surgery (HR: 3.02; 95% CI: 1.02-8.92) were associated. High ASA, NNIS risk, and inadequate prophylaxis significantly decreased (P < .001). The intervention reduced SSI risk by 66% (HR: 0.34; 95% CI: 0.13-0.94; P = .037). A nonsignificant reduction was seen in high-risk strata. Conclusions: Our study showed the impact of an IPC intervention addressing associated factors and significantly reducing SSI incidence rates.

Matèries

Genoll, Infeccions nosocomials

Matèries (anglès)

Knee, Nosocomial infections

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Articles publicats en revistes (Infermeria de Salut Pública, Salut mental i Maternoinfantil)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

ZULES OÑA, Ricardo, et al. Risk factors of surgical site infection in total knee arthroplasty: Impact of an infection prevention and control intervention in a tertiary hospital in Barcelona, Spain. American Journal of Infection Control. 2026. Vol. 54, num. 6, pags. 626-631. ISSN 0196-6553. [consulted: 2 of July of 2026]. Available at: https://hdl.handle.net/2445/230305

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