Wound Infections in General Surgery with Special Reference to the Occurrence of Staphylococcus Aureus

Abstract

The epidemiology of postoperative wound infections in general surgery was studied on 2 827 patients during a 14-month period with special reference to Staphylococcus aureus. The overall infection rate was 7.5%. Isolates from 61 out of 63 patients infected with Staph. aureus were phage typed. Staphylococci with phage types related to infecting strains were searched for in the environment of all patients before and after admission as well as during and after operation. Such strains were frequently found in the wards before the admission of subsequently infected patients. 20% of the patients investigated with nose cultures in the theatre were shown to be colonized with subsequently infecting strains. In another 14 % such strains were isolated only from the wound or the skin peroperatively. During the first 3 postoperative days infecting strains were significantly more frequent in the immediate surrounding of the infected patient than in corresponding cultures from his fellow patients, nursed in the same room. Carriers of strains related to infecting strains were more frequent among personnel in the theatre than among staff in general wards. The results indicate frequent possibilities of preoperative colonization of the patient in general wards, while inoculation of the surgical wound seems to occur in the operation theatre, either from sources within this department, from strains brought there with the patient or through other communications with the infected ward.