scholarly journals Epidemiology of Surgical Site Infection in a Community Hospital Network

2016 ◽  
Vol 37 (5) ◽  
pp. 519-526 ◽  
Author(s):  
Arthur W. Baker ◽  
Kristen V. Dicks ◽  
Michael J. Durkin ◽  
David J. Weber ◽  
Sarah S. Lewis ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Prevalence Rate ◽  
Colon Surgery ◽  
Causative Organism ◽  
Site Infection ◽  
Prevalence Rates ◽  
Community Hospitals ◽  
Bowel Surgery ◽  
Prevalence Rate Ratio ◽  
Over Time

OBJECTIVETo describe the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogensMETHODSWe prospectively collected SSI data at 29 community hospitals in the southeastern United States from 2008 through 2012. We determined the overall prevalence rates of SSI for commonly performed procedures during this 5-year study period. For each year of the study, we then calculated prevalence rates of SSI stratified by causative organism. We created log-binomial regression models to analyze trends of SSI prevalence over time for all pathogens combined and specifically for MRSA.RESULTSA total of 3,988 complex SSIs occurred following 532,694 procedures (prevalence rate, 0.7 infections per 100 procedures). SSIs occurred most frequently after small bowel surgery, peripheral vascular bypass surgery, and colon surgery. Staphylococcus aureus was the most common pathogen. The prevalence rate of SSI decreased from 0.76 infections per 100 procedures in 2008 to 0.69 infections per 100 procedures in 2012 (prevalence rate ratio [PRR], 0.90; 95% confidence interval [CI], 0.82–1.00). A more substantial decrease in MRSA SSI (PRR, 0.69; 95% CI, 0.54–0.89) was largely responsible for this overall trend.CONCLUSIONSThe prevalence of MRSA SSI decreased from 2008 to 2012 in our network of community hospitals. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence over the study period.Infect Control Hosp Epidemiol 2016;37:519–526

Severe Surgical Site Infection in Community Hospitals: Epidemiology, Key Procedures, and the Changing Prevalence of Methicillin-Resistant Staphylococcus aureus

2007 ◽  
Vol 28 (9) ◽  
pp. 1047-1053 ◽  
Author(s):  
Deverick J. Anderson ◽  
Daniel J. Sexton ◽  
Zeina A. Kanafani ◽  
Grace Auten ◽  
Keith S. Kaye
Keyword(s):  
Surgical Site Infection ◽  
Prevalence Rate ◽  
Site Infection ◽  
Prevalence Rates ◽  
Community Hospitals ◽  
Methicillin Resistant ◽  
The Past ◽  
Prevalence Rate Ratio ◽  
Trend Data ◽  
A Prospective Study

Objective.To characterize the epidemiology of severe (ie, nonsuperficial) surgical site infection (SSI) in community hospitals.Methods.SSI data were collected prospectively at 26 community hospitals in the southeastern United States. Two analyses were performed: (1) a study of the overall prevalence rates of SSI and the prevalence rates of SSI due to specific pathogens in 2005 at all participating hospitals and (2) a prospective study of consecutive surgical procedures at 9 of the 26 community hospitals from 2000 through 2005.Results.In 2005, a total of 1,010 SSIs occurred after 89,302 procedures (prevalence rate, 1.13 infections per 100 procedures). Methicillin-resistant S. aureus (MRSA) was the pathogen most commonly recovered (from 175 SSIs). Trend data from 2000 through 2005 demonstrated that the prevalence rate of MRSA SSI almost doubled during this period, increasing from 0.12 infections per 100 procedures (95% confidence interval [CI], 0.12-0.13) to 0.23 infections per 100 procedures (95% CI, 0.22-0.24) (P<.0001). In adjusted analysis, MRSA SSI was significantly more prevalent at the end of the study period than at the beginning (prevalence rate ratio, 1.48 [95% CI, 1.36-1.61]; P<.0001).Conclusions.MRSA was the pathogen that most commonly caused SSI in our network of community hospitals during 2005. The prevalence of MRSA SSI has increased significantly over the past 6 years.

scholarly journals Risk factors for surgical site infection in colon surgery in our population

2018 ◽  
Vol 75 (4) ◽  
pp. 229
Author(s):  
Santiago Olguín Joseau ◽  
Natalia Paola Bollati ◽  
Santiago Reimondez ◽  
Franco Signorini ◽  
Alejandro Mario Rossini ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Odds Ratio ◽  
Colon Surgery ◽  
Site Infection ◽  
Quimioterapia Neoadyuvante ◽  
Factores De Riesgo

<p>Introducción: La infección de sitio quirúrgico (ISQ) es la infección intrahospitalaria más frecuente en los pacientes quirúrgicos con una incidencia entre 5-30%. Objetivos: Identificar los factores de riesgo para ISQ en cirugía colónica en nuestra población. Los objetivos secundarios son determinar la incidencia y tipo de ISQ, así como la incidencia de dehiscencia de anastomosis (DA). Materiales y métodos: Estudio de casos-controles de pacientes intervenidos de colectomía entre 2010-2014 en el Hospital Privado Universitario de Córdoba y Hospital Raúl Ferreyra. Se incluyeron las intervenciones convencionales y laparoscópicas, con seguimiento de 30 días, pacientes entre 20 y 85 años y con ASA I-III. Se excluyeron las cirugías de urgencia y las resecciones recto-anales. Se definió ISQ a aquella que ocurre dentro de 30 días. Resultados: Se incluyeron 238 pacientes. Se diagnosticó ISQ en 27,7% (n=66) de los pacientes de los cuales 12,2% fue superficial, 4,6% profunda y 10,9% de órgano/espacio. El análisis multivariado demostró que la ISQ se asocia con sexo masculino (odds ratio [OR] 3,15; IC95%:1,43-6,92; p=0,004), quimioterapia neoadyuvante (OR 6,72; IC95%:1,48-30,93; p=0,01), conversión (OR 3,32; IC95%:1,13-9,77; p=0,02), reintervención dentro de 30 días postquirúrgicos (OR 12,34; IC95%:2,65-57,37, p=0,001) y DA (OR 12,83; IC95%:2,97- 55,5; p=0,001). La DA presenta una incidencia del 9,6%, de los cuales el 91% presentó ISQ y todas fueron de órgano/espacio. Conclusión: Sexo masculino, quimioterapia neoadyuvante, conversión, reintervención dentro de 30 días postquirúrgicos y DA son factores de riesgo para ISQ en nuestra población. Estos resultados deben ser considerados para implementar medidas preventivas para ISQ.</p>

scholarly journals 909Comparison of three different data sources for Surgical Site Infection (SSI) Surveillance after Colon Surgery

2014 ◽  
Vol 1 (suppl_1) ◽  
pp. S262-S262
Author(s):  
Teresa Childers ◽  
Shauna C Usiak ◽  
Mindy Sovel ◽  
Luke Selby ◽  
Vivian Strong ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Data Sources ◽  
Site Infection

scholarly journals First Results of the Swiss National Surgical Site Infection Surveillance Program: Who Seeks Shall Find

2017 ◽  
Vol 38 (06) ◽  
pp. 697-704 ◽  
Author(s):  
Nicolas Troillet ◽  
Emin Aghayev ◽  
Marie-Christine Eisenring ◽  
Andreas F. Widmer ◽  
Keyword(s):  
Surgical Site Infection ◽  
Temporal Trends ◽  
Colon Surgery ◽  
Surveillance Program ◽  
Site Infection ◽  
Post Discharge ◽  
Public And Private ◽  
Logistic Regression Models ◽  
First Results ◽  
The Impact

OBJECTIVES To report on the results of the Swiss national surgical site infection (SSI) surveillance program, including temporal trends, and to describe methodological characteristics that may influence SSI rates DESIGN Countrywide survey of SSI over a 4-year period. Analysis of prospectively collected data including patient and procedure characteristics as well as aggregated SSI rates stratified by risk categories, type of SSI, and time of diagnosis. Temporal trends were analyzed using stepwise multivariate logistic regression models with adjustment of the effect of the duration of participation in the surveillance program for confounding factors. SETTING The study included 164 Swiss public and private hospitals with surgical activities. RESULTS From October 2011 to September 2015, a total of 187,501 operations performed in this setting were included. Cumulative SSI rates varied from 0.9% for knee arthroplasty to 14.4% for colon surgery. Postdischarge follow-up was completed in &gt;90% of patients at 1 month for surgeries without an implant and in &gt;80% of patients at 12 months for surgeries with an implant. High rates of SSIs were detected postdischarge, from 20.7% in colon surgeries to 93.3% in knee arthroplasties. Overall, the impact of the duration of surveillance was significantly and independently associated with a decrease in SSI rates in herniorraphies and C-sections but not for the other procedures. Nevertheless, some hospitals observed significant decreases in their rates for various procedures. CONCLUSIONS Intensive post-discharge surveillance may explain high SSI rates and cause artificial differences between programs. Surveillance per se, without structured and mandatory quality improvement efforts, may not produce the expected decrease in SSI rates. Infect Control Hosp Epidemiol 2017;38:697–704

scholarly journals Incidence and risk factors of surgical site infection following colorectal surgery in Iran: a prospective cohort study

2021 ◽  
Author(s):  
Siamak Rajaei ◽  
Masoud Mohammadi ◽  
Mohammad Hosein Taziki Balajelini ◽  
Reza Afghani ◽  
Mehrshad Zare ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Surgical Site Infection ◽  
Colon Surgery ◽  
Site Infection ◽  
Prospective Design ◽  
Related Risk ◽  
Scientific Principles ◽  
Golestan Province ◽  
Univariate Analyses

Abstract Background Surgical site infection (SSI) after colorectal surgery remains a significant problem for its negative clinical outcomes. The aim of this study was to determine the incidence of SSI after colorectal surgery in 5-Azar hospital of Gorgan, Golestan province, Iran and to further evaluate the related risk factors. Methods A prospective design was applied. Patients in the 5-Azar hospital of Gorgan, Golestan province, Iran was prospectively monitored for SSI after colorectal surgery. The demographic and perioperative characteristics were collected, and the main outcome were SSI within postoperative 30 days. Univariate analyses were used to identify risk factors. Results A total of 240 patients were enrolled in the study and the overall SSI rate was 23.3% (56 patients). Univariate analyses indicated that corticosteroids use (Risk Ratio (RR) = 3, 95% CI: 1.62–5.54), segmental resection with anastomosis (RR = 2.28, 95% CI: 1.12–4.63), anemia (RR = 4.52, 95% CI: 3.11–6.59), diabetics (RR = 2.68, 95% CI: 1.73–4.14), and opium use (RR = 1.87, 95% CI: 1.17–2.99) are risk factors for SSI. Conclusions SSI still seems to be a problem in colon surgery despite the observance of scientific principles. There are some risk factors for SSI that can be prevented.

Protocol-Driven Reduction in Surgical Site Infection after Colon Surgery

2018 ◽  
Vol 227 (4) ◽  
pp. e111
Author(s):  
Carolina Martinez ◽  
Nkechinye P. Omesiete ◽  
Viraj Pandit ◽  
Yadira Villalvazo ◽  
Meleesa Nocera ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Site Infection

scholarly journals The association between the increased performance of laparoscopic colon surgery and a reduced risk of surgical site infection

Surgery Today ◽  
2019 ◽  
Vol 49 (6) ◽  
pp. 474-481 ◽  
Author(s):  
Yoshinori Kagawa ◽  
Daisaku Yamada ◽  
Makoto Yamasaki ◽  
Atsushi Miyamoto ◽  
Tsunekazu Mizushima ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Site Infection ◽  
Laparoscopic Colon Surgery ◽  
Laparoscopic Colon ◽  
Reduced Risk

Prevalence and risk factors for surgical site infection after colorectal surgery: a multiple-center prospective study of 3,663 consecutive patients in China

2020 ◽  
Author(s):  
Yu Zhang ◽  
Hui-Quan Gan ◽  
Jing-Fang Zhou ◽  
Ya-Jie Gong ◽  
Liu-Yi Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Colorectal Surgery ◽  
Surgical Site Infection ◽  
Prevalence Rate ◽  
Demographic Data ◽  
Risk Index ◽  
Klebsiella Pneumonia ◽  
Site Infection ◽  
Extended Spectrum Beta Lactamase

Abstract Background: Surgical site infection (SSI) after colorectal surgery (CRS) remains a significant problem for its negative clinical outcomes. However, it is poorly understood in China . This study aims to investigate the prevalence, risk factors and microbiology of SSI after CRS. Methods: A nationwide prospective multicenter design was applied. Patients in 19 Chinese hospitals from 2015 to 2018 were prospectively monitored for SSI after CRS. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using univariate and multivariate logistic regression models. Results: Among 3,663 study participants, 134(3.66%) episodes of SSI were identified. The prevalence rate of SSI decreased from 5.9 infections per 100 procedures in 2014 to 3.1 infections per 100 procedures in 2017 (prevalence rate ratio [PRR], 0.52; 95% CI, 0.28–0.94). The SSI rates were 1.88, 4.15, 6.27 and 11.58 per 100 operations for the National Nosocomial Infections Surveillance system (NNIS) risk index categories of 0, 1, and 2 or 3, respectively. Escherichia coli (54/134, 40.3%) and Klebsiella pneumoniae (10/134, 7.5%) were the most frequently isolated microorganisms. A high prevalence of antibiotic resistance were observed in our study, with rates of extended spectrum beta-lactamase-producing or carbapenem-resistant Escherichia coli and Klebsiella pneumonia of 50.0%(27/54) and 30.0%(3/10) respectively. Preoperative hospital stay ≥ 48h (OR=2.28, 95% CI: 1.03–5.02) and contaminated or dirty wound (OR=3.38, 95% CI: 1.88–6.06) were significantly associated with increasing risk of SSI after CRS. Conclusion: A statistically significant but modest decrease in the prevalence rate of CRS SSI over the 4-year study period was observed in this study. Noticeably, the relatively high rates of multidrug-resistant pathogens causing SSI after CRS should be alert despite of the small number of isolates identified in our survey.

scholarly journals Colon surgery: does the “bundle” approach reduce the surgical site infection risk?

2017 ◽  
Vol 27 (suppl_3) ◽  
Author(s):  
A D'Ambrosio ◽  
IN Emelurumonye ◽  
F Quattrocolo ◽  
CM Zotti ◽  
MF Furmenti
Keyword(s):  
Surgical Site Infection ◽  
Colon Surgery ◽  
Infection Risk ◽  
Site Infection

Value-based purchasing may unfairly penalize specialty centers performing combined liver–colon multivisceral resections

2018 ◽  
Vol 23 (4) ◽  
pp. 143-148
Author(s):  
Ira L Leeds ◽  
Peter J Pronovost ◽  
J Matthew Austin ◽  
Elliott R Haut
Keyword(s):  
Linear Regression ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Risk Adjustment ◽  
Surgical Site Infections ◽  
Multivisceral Resection ◽  
Colon Surgery ◽  
Site Infection ◽  
Surgical Site Infection Rate ◽  
Value Based Purchasing

Background Some of the measures in value-based purchasing programs may be flawed due to inadequate risk adjustment. The purpose of this study was to examine the effect of the surgical casemix on surgical site infection rates using combined colectomy–hepatectomy resections as a test case. Methods We identified all adult patients undergoing elective colon surgery (2007–2013) in the National Inpatient Sample. We defined patients with a concurrent liver resection as “multivisceral resections.” Cases from each hospital were pooled by hospital identifier. The association between surgical site infection rate and the proportion of multivisceral resections performed was compared statistically. Findings were further tested for independence against hospital-level characteristics similar to risk-adjusted surgical site infection rate reporting. Results We identified 1014 hospitals performing 127,646 colon surgeries including 1168 (0.9%) multivisceral resections. The overall surgical site infection rate for multivisceral resection was 11.3% versus 1.6% for colectomy-only resections (p < 0.001). Simple linear regression demonstrated a 2.3% increase in a hospital’s surgical site infection rate for each 1% increase in the proportion of multivisceral resections performed. Multivariable linear regression demonstrated a preserved association. Conclusion A hospital’s rate of surgical site infections is positively associated with the proportion of multivisceral resections performed. Value-based purchasing programs should assess readily available data for further risk-adjustment inclusion.

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