Surgical site infection surveillance and the predictive power of the National Nosocomial Infection Surveillance index as compared with alternative determinants in The Netherlands

2008 ◽  
Vol 36 (3) ◽  
pp. S27-S31 ◽  
Author(s):  
Mårten Kivi ◽  
Judith Manniën ◽  
Jan C. Wille ◽  
Susan van den Hof
Keyword(s):  
The Netherlands ◽  
Nosocomial Infection ◽  
Surgical Site Infection ◽  
Predictive Power ◽  
National Nosocomial Infection Surveillance ◽  
Site Infection ◽  
Infection Surveillance

Surveillance for Surgical Site Infection (SSI) After Neurosurgery: Influence of the US or Brest (France) National Nosocomial Infection Surveillance Risk Index on SSI Rates

2008 ◽  
Vol 29 (11) ◽  
pp. 1084-1087 ◽  
Author(s):  
Claire Lietard ◽  
Véronique Thébaud ◽  
Gérard Besson ◽  
Benoist Lejeune
Keyword(s):  
Nosocomial Infection ◽  
Surgical Site Infection ◽  
Risk Index ◽  
Surveillance Data ◽  
National Nosocomial Infection Surveillance ◽  
Site Infection ◽  
Local Operation ◽  
Infection Surveillance ◽  
Neurosurgical Patients ◽  
The Us

A total of 5,628 neurosurgical patients were observed in France to assess the occurrence of surgical site infection (SSI). Their risk of SSI was defined by calculating both the US National Nosocomial Infection Surveillance and the Brest National Nosocomial Infection Surveillance risk indexes. This study compares SSI rates stratified according to either the US or Brest (France) National Nosocomial Infection Surveillance risk index. The SSI rates were correlated with National Nosocomial Infection Surveillance data involving only local operation durations.

Validation of Surgical Site Infection Surveillance in The Netherlands

2007 ◽  
Vol 28 (1) ◽  
pp. 36-41 ◽  
Author(s):  
J. Manniën ◽  
A. E. van der Zeeuw ◽  
J. C. Wille ◽  
S. van den Hof
Keyword(s):  
Surgical Site Infection ◽  
Predictive Value ◽  
Medical Records ◽  
Surveillance System ◽  
Structured Interview ◽  
Surveillance Data ◽  
National Nosocomial Infection Surveillance ◽  
Site Infection ◽  
Infection Surveillance

Objectives.To describe how continuous validation of data on surgical site infection (SSI) is being performed in the Dutch National Nosocomial Infection Surveillance System (Preventie Ziekenhuisinfecties door Surveillance [PREZIES]), to assess the quality and accuracy of the PREZIES data, and to present the corresponding outcomes of the assessment.Design.Mandatory, 1-day on-site validation visit to participating hospitals every 3 years. The process of surveillance, including the quality of the method of data collection, is validated by means of a structured interview. The use of SSI criteria is validated by review of medical records, with the judgment of the validation team as the criterion standard.Setting.Hospitals participating in PREZIES.Results.During 1999-2004, the validation team visited 40 hospitals and reviewed 859 medical charts. There was no deviation between reports of SSI by infection control professionals and findings by the PREZIES validation team at 30 hospitals and 1 deviation in each of 10 hospitals; the positive predictive value was 0.97, and the negative predictive value was 0.99. The validation team often gave advice to the hospital, aimed at perfecting the process of surveillance. On 2 occasions, data were removed from the PREZIES database after the validation visit revealed deviations from the SSI surveillance protocol that could have resulted in nonrepresentative SSI rate data.Conclusions.PREZIES is confident that the assembled Dutch SSI surveillance data are reliable and robust and are sufficiently accurate to be used as a reference for interhospital comparison. PREZIES will continue performing on-site validation visits, to improve the process of surveillance and ensure the reliability of the surveillance data.

Comparison of the National Surgical Site Infection surveillance data between The Netherlands and Germany: PREZIES versus KISS

2007 ◽  
Vol 66 (3) ◽  
pp. 224-231 ◽  
Author(s):  
J. Manniën ◽  
S. van den Hof ◽  
C. Brandt ◽  
M. Behnke ◽  
J.C. Wille ◽  
...  
Keyword(s):  
The Netherlands ◽  
Surgical Site Infection ◽  
Surveillance Data ◽  
Site Infection ◽  
Infection Surveillance

Improved Risk Adjustment for Comparison of Surgical Site Infection Rates

2006 ◽  
Vol 27 (12) ◽  
pp. 1330-1339 ◽  
Author(s):  
Eveline L. P. E. Geubbels ◽  
Diederick E. Grobbee ◽  
Christina M. J. E. Vandenbroucke-Grauls ◽  
Jan C. Wille ◽  
Annette S. de Boer
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Risk Adjustment ◽  
Predictive Power ◽  
Hip Prosthesis ◽  
Risk Index ◽  
Site Infection ◽  
Total Hip Prosthesis ◽  
Infection Surveillance ◽  
Femorotibial Bypass

Objective.To develop prognostic models for improved risk adjustment in surgical site infection surveillance for 5 surgical procedures and to compare these models with the National Nosocomial Infection Surveillance system (NNIS) risk index.Design.In a multicenter cohort study, prospective assessment of surgical site infection and risk factors was performed from 1996 to 2000. In addition, risk factors abstracted from patient files, available in a national medical register, were used. The c-index was used to measure the ability of procedure-specific logistic regression models to predict surgical site infection and to compare these models with models based on the NNIS risk index. A c-index of 0.5 indicates no predictive power, and 1.0 indicates perfect predictive power.Setting.Sixty-two acute care hospitals in the Dutch national surveillance network for nosocomial infections.Participants.Patients who underwent 1 of 5 procedures for which the predictive ability of the NNIS risk index was moderate: reconstruction of the aorta (n= 875), femoropopliteal or femorotibial bypass (n= 641), colectomy (n= 1,142), primarytotal hip prosthesis (n= 13,770), and cesarean section (n= 2,962).Results.The predictive power of the new model versus the NNIS index was 0.75 versus 0.62 for reconstruction of the aorta (P< .01), 0.78 versus 0.58 for femoropopliteal or femorotibial bypass (P< .001), 0.69 versus 0.62 for colectomy (P< .001), 0.64 versus 0.56 for primary total hip prosthesis arthroplasty (P< .001), and 0.70 versus 0.54 for cesarean section (P< .001).Conclusion.Data available from hospital information systems can be used to develop models that are better at predicting the risk of surgical site infection than the NNIS risk index. Additional data collection may be indicated for certain procedures–for example, total hip prosthesis arthroplasty.

USE OF AN ELECTRONIC DATA WAREHOUSE TO ENHANCE CARDIAC SURGICAL SITE SURVEILLANCE AT A LARGE CANADIAN CENTRE

2008 ◽  
Vol 31 (4) ◽  
pp. 21 ◽  
Author(s):  
G W Rose ◽  
V R Roth ◽  
K N Suh ◽  
M Taljaard ◽  
C Van Walraven ◽  
...  
Keyword(s):  
Infection Control ◽  
Surgical Site Infection ◽  
Data Warehouse ◽  
Stepwise Logistic Regression ◽  
Site Infection ◽  
Electronic Data ◽  
Trigger Mechanism ◽  
Trigger Tool ◽  
Infection Surveillance ◽  
Trigger Mechanisms

Background/Purpose: Surgical site infection surveillance to determineincidence is a key infection control activity. Case detection is labour-intensive, therefore most infection control programs use manual or simple electronic mechanisms to “trigger” chart review. However, such “trigger” mechanisms are also labour-intensive, and often of poor specificity. Our objective is to develop a complex trigger mechanism using data from an electronic data warehouse, to improve specificity of surveillance of surgical site infection compared to current trigger mechanisms. Methods: We will derive an electronic trigger tool for cardiac surgical site infection surveillance using a nested case-control design, among a cohort of all patients undergoing coronary artery bypass grafting, cardiac valve repairor replacement, or heart transplant at the University of Ottawa Heart Institute, from July 1 2004 to June 30 2007. We will perform a systematic literature review to identify potential trigger factors to include in the model, then construct the trigger tool by backwards stepwise logistic regression. The best-fit model will be used to calculate the probability of surgical site infection. We will select the threshold probability to use in surveillance by visual inspection of receiver-operator-characteristic curves. The accuracy of this electronic trigger mechanism will be compared to pre-existing manual and simple electronic mechanisms using relative true positive ratios and relative false positive ratios. Results/Conclusions: We have selected 200 cases of surgical site infection and 541 controls from among 3744 procedures performed during the study period. As of the date ofthis abstract we are still undertaking the systematic review.

scholarly journals Cerebrospinal Fluid Shunt-Associated Surgical Site Infection With Three- Versus Twelve-Month Follow-Up in Canadian Hospitals

2020 ◽  
Vol 41 (S1) ◽  
pp. s157-s157
Author(s):  
Kelly Baekyung Choi ◽  
John Conly ◽  
Blanda Chow ◽  
Joanne Embree ◽  
Bonita Lee ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Age Distribution ◽  
Patient Characteristics ◽  
Csf Shunt ◽  
Surveillance Program ◽  
Site Infection ◽  
Infection Surveillance ◽  
Surgical Manipulation ◽  
National Systems

Background: Surgical site infection (SSI) after cerebrospinal fluids (CSF) shunt surgery is thought to be acquired intraoperatively. Biomaterial-associated infection can present up to 1 year after surgery, but many national systems have shortened follow-up to 90 days. We compared 3- versus 12-month follow-up periods to determine the nature of case ascertainment in the 2 periods. Methods: Participants of any age with placement of an internal CSF shunt or revision surgical manipulation of an existing internal shunt identified in the Canadian Nosocomial Infection Surveillance Program (CNISP) participating hospitals between 2006 and 2018 were eligible. We excluded patients with external shunting devices or culture-positive CSF at the time of surgery. Patients were followed for 12 months after surgery for the primary outcome of a CSF infection with a positive CSF culture by review of laboratory and health records. Patients were categorized as adult (aged ≥18 years) or pediatric (aged < 18 years). The infection rate was expressed as the number of CSF shunt-associated infections divided by the number of shunt surgeries per 100 procedures. Results: In total, 325 patients (53% female) met inclusion criteria in 14 hospitals from 7 provinces were identified. Overall, 46.1% of surgeries were shunt revisions and 90.3% of shunts were ventriculoperitoneal. For pediatric patients, the median age was 0.7 years (IQR, 0.2–7.0). For adult patients, the median age was 47.9 years (IQR, 29.6–64.6). The SSI rates per 100 procedures were 3.69 for adults and 3.65 for pediatrics. The overall SSI rates per 100 procedures at 3 and 12 months were 2.74 (n = 265) and 3.48 (n = 323), respectively. By 3 months (90 days), 82% of infection cases were identified (Fig. 1). The median time from procedure to SSI detection was 30 days (IQR, 10–65). No difference was found in the microbiology of the shunt infections at 3- and 12-month follow-ups. The most common pathogens were coagulase-negative Staphylococcus (43.6 %), followed by S. aureus (24.8 %) and Propionibacterium spp (6.5 %). No differences in age distribution, gender, surgery type (new or revision), shunt type, or infecting organisms were observed when 3- and 12-month periods were compared. Conclusions: CSF-SSI surveillance for 3 versus 12 months would capture 82.0% (95% CI, 77.5–86.0) of cases, with no significant differences in the patient characteristics, surgery types, or pathogens. A 3-month follow-up can reduce resources and allow for more timely reporting of infection rates.Funding: NoneDisclosures: None

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