International Infection Prevention Week has been highlighting the importance of infection prevention every October since 1986. The topic is still highly relevant: According to the European Centre for Disease Prevention and Control 4.8 million infections after a medical procedure are acquired each year in the EU [1]. The International Week for Infection Prevention aims to raise awareness among healthcare professionals and general public of the role each individual plays in infection prevention. The motto of this year's campaign week from October 13th to 19th is “Moving the Needle on Infection Prevention”. It stands for the improvement of infection prevention.
Joined forces for better infection prevention
Surgical site infections
In the EU each year 4.3 million patients develop at least one healthcare-associated infection [1]. Up to 70 % of these healthcare-associated infections are considered preventable [2]. Surgical site infections (SSI) are with 16,1 % one of the most common types of healthcare-associated infections [1]. Infections that occur after surgery can be superficial or affect deeper tissues, organs and implanted materials. Pathogenic bacteria are often the cause; viruses or fungi play a rarer role. The exact pathogens that trigger an SSI generally depend on the type of surgery [3, 4]. For example, facultative pathogens only become problematic in combination with additional factors, such as the insertion of an implant.
Depending on the surgical procedure, different pathogens play a role in SSI
The bacterium Staphylococcus aureus is the most common pathogen causing SSI in Germany [3]. According to data from the National Reference Center for healthcare-associated Infections (NRZ), S. aureus is found in 20 % of all SSI isolates [3]. SSIs with S. aureus occur in particular after cardiologic and orthopaedic procedures [3]. Colonization of the patient's nose with S. aureus is an important risk factor for this. Preoperative screening and decolonization can reduce the risk of infection [3].
Intestinal bacteria are responsible for most SSIs in abdominal surgery. Escherichia coli can be detected most frequently, followed by Enterococcus spp. (E. faecium and E. faecalis) [3, 4]. In certain operations, bowel evacuation in combination with antibiotics may therefore be advisable to prevent infection [3].
During orthopaedic surgery, pathogens such as S. aureus or coagulase-negative staphylococci (CoNS) from the skin flora can cause a bone infection [5]. The bacterium Propionibacterium acnes prefers to colonize the skin of the shoulder and axilla and therefore frequently causes SSI after shoulder surgery.
Serious complications: orthopaedic surgical site infections
The risk of SSI is particularly high during operations in which foreign materials are inserted, e.g. hip joint replacement. The material properties of the implant can favor the adhesion of bacteria [3]. Periprosthetic joint infection (PJI) is a serious postoperative complication of joint arthroplasty procedures. It is associated with considerable morbidity and mortality [6]. Due to the increasing number of primary hip and knee endoprotheses, the incidence of PJI is increasing. The incidence of PJI after primary arthroplasty is estimated to be around 1 to 2 %. PJI is also one of the most common causes of revision surgery [7-9].
Various strategies have been developed to prevent the development of PJI in the preoperative, perioperative and postoperative phases [6]. For example, intraoperative irrigation, which is used in arthroplasty after implantation of the final components, can counteract the formation of biofilms [6]. Another effective option is the use of an antimicrobial surgical irrigation solution based on PHMB (polyhexanide) and poloxamer [10].
Up to date on infection prevention with the M: IP® SSI Knowledge Hub
With the M: IP® SSI Knowledge Hub, Hartmann offers healthcare professionals easy online access to SSI prevention measures. Staff shortages and increasing demands in the healthcare sector make it difficult to keep an overview and stay up to date. That is why the M: IP® SSI Knowledge Hub summarizes the most important guidelines of the leading national and international institutions (WHO, CDC, NICE, KRINKO), supplemented by HARTMANN's medical know-how from 200 years of experience. The innovative platform presents evidence-based findings and practice-oriented approaches in a user-friendly way, helping you to keep your knowledge of infection prevention up to date and to expand it. Visit the M: IP® SSI Knowledge Hub and discover a world with less infections!
Mission: Infection Prevention – together strong against infections
The M: IP® SSI Knowledge Hub is part of our “Mission: Infection Prevention”. M: IP® aims to reduce the incidence of healthcare-associated infections in healthcare facilities. This leads to less stress for medical staff and better patient care. At the same time, reputational and financial risks can be avoided.
As part of the German Congress for Orthopaedics and Trauma Surgery (DKOU) from October 22nd to 25th in Berlin, there will be a panel discussion on Mission: Infection Prevention with the title "The challenge of PJI and FRI - thinking ahead about prevention". Experts will discuss effective measures that can be used to effectively prevent SSIs. The event will take place on October 25th from 10 a.m. to 11 a.m. in Hall 4.2.
Join us and show your commitment to infection prevention – whether you are a medical professional or a healthcare worker! Let's break new ground together in infection prevention for the highest quality of results for the benefit of patients!
#MissionInfectionPrevention
References:
- European Centre for Disease Prevention and Control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. Stockholm: ECDC; 2024.
- https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control
- Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI). Prävention postoperativer Wundinfektionen. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2018; 61: 448-473.
- Weiner LM et al. Antimicrobial-Resistant Pathogens Associated With : Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014. Infect Control Hosp Epidemiol 2016; 37: 1288-1301.
- Masters EA et al. Skeletal infections: microbial pathogenesis, immunity and clinical management. Nat Rev Microbiol 2022; 20: 385-400.
- Rupp M et al. Recent trends in revision knee arthroplasty in Germany. Scientific Reports 2021; 11: 15479.
- Zeng ZJ et al. Incidence of periprosthetic joint infection after primary total hip arthroplasty is underestimated: a synthesis of meta analysis and bibliometric analysis. J Orthop Surg Res 2023; 18: 610.
- Jin X et al. Estimating incidence rates of periprosthetic joint infection after hip and knee arthroplasty for osteoarthritis using linked registry and administrative health data. Bone Joint J 2022; 104-B(9): 1060–6.
- Ayoade F et al. Periprosthetic Joint Infection. In: StatPearls Publishing; 2024. https://www.ncbi.nlm.nih.gov/books/NBK448131
- In-vitro results on planktonic time kill assay to evaluate the bactericidal activity of chemical disinfectants and antiseptics. Data on file.