Surgical wound infections due to Pseudomonas aeruginosa in orthopedic surgery

Objective. - The department of infection control carried out an investigation to search for the origin of 4 surgical site infections and 1 wound colonization by Pseudomonas aeruginosa in patients having undergone orthopedic surgery. Patients and methods. - The authors retrospectively reviewed the medical records, the clinical data of the operating units, as well as the bacteriological assessments of the infected patients. Multiple environmental samples were made to screen for P. aeruginosa and care giving was evaluated. Results. - The 5 patients underwent surgery between August and September 2001 with various surgeons and were followed-up by various paramedics. The surgical procedures were varied and performed in different operating rooms. Various P. aeruginosa serotypes were isolated. No specific event could be related to the infections concerning the surgical procedures. In 3 of the 5 patients, non-sterile cotton jersey had been used, either normally (plaster or plaster splint) or after sterilization (wrapping of wounded limbs before surgical procedure). The culture samplings of non-sterile jersey were always contaminated by Enterobacteriaceae or Pseudomonas sp., with 2 positives cultures of P. aeruginosa. Only one water sample was positive, whereas other environmental samples remained negative. The reorganization of jersey supply put an end to this epidemic phenomenon. Conclusion. - The most probable hypothesis for surgical wound infection was the cotton jersey in 3 of the 5 cases. (c) 2005 Publie par Elsevier SAS.