Laminar Airflow Ceiling Size: No Impact on Infection Rates Following Hip and Knee Prosthesis

2011 ◽  
Vol 32 (11) ◽  
pp. 1097-1102 ◽  
Author(s):  
Ann-Christin Breier ◽  
Christian Brandt ◽  
Dorit Sohr ◽  
Christine Geffers ◽  
Petra Gastmeier
Keyword(s):  
Orthopedic Surgery ◽  
Surveillance System ◽  
Generalized Estimating Equations ◽  
Hip Prosthesis ◽  
Knee Prosthesis ◽  
Infection Risk ◽  
National Nosocomial Infection Surveillance ◽  
Infection Rates ◽  
Infection Surveillance ◽  
Lower Infection

Objective.Laminar airflow (LAF) systems are widely used, at least in orthopedic surgery. However, there is still controversial discussion about the influence of LAF on surgical site infection (SSI) rates. The size of the LAF ceiling is also often a question of debate. Our objective is to determine the effect of this technique under conditions of actual rather than ideal use.Design.Cohort study using multivariate analysis with generalized estimating equations method.Setting.Data for hip and knee prosthesis procedures from hospitals participating in the German national nosocomial infection surveillance system (KISS) from July 2004 to June 2009 were used for analysis.Patients.A total of 33,463 elective hip prosthesis procedures due to arthrosis (HIP-A) from 48 hospitals, 7,749 urgent hip prosthesis procedures due to fracture (HIP-F) from 41 hospitals, and 20,554 knee prosthesis (KPRO) procedures from 38 hospitals were included.Methods.The data were analyzed for hospitals with and without LAF in the operating rooms and by the size of the LAF ceiling. The endpoints were severe SSI rates.Results.The overall severe SSI rate was 0.74 per 100 procedures for HIP-A, 2.39 for HIP-F, and 0.63 for KPRO. For all 3 prosthesis types, neither LAF nor the size of the LAF ceiling was associated with lower infection risk.Conclusions.The data demonstrate consistency and reproducibility with the results from earlier registry studies. Neither LAF nor ceiling size had an impact on severe SSI rates.

Reproducibility of the Surveillance Effect to Decrease Nosocomial Infection Rates

2009 ◽  
Vol 30 (10) ◽  
pp. 993-999 ◽  
Author(s):  
P. Gastmeier ◽  
F. Schwab ◽  
D. Sohr ◽  
M. Behnke ◽  
C. Geffers
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Intensive Care Units ◽  
Surveillance System ◽  
Knee Prosthesis ◽  
Venous Catheter ◽  
Infection Rates ◽  
Relative Risks ◽  
Infection Surveillance ◽  
Reduction Effect

Objective.To investigate whether the reduction effect due to participation in a nosocomial infection surveillance system for laboratory-confirmed central venous catheter (CVC)-associated primary bloodstream infection (BSI), ventilator-associated pneumonia (VAP), and surgical site infection (SSI) is reproducible for different time periods, independent of confounding factors that might occur during a specific time period.Methods.Data from the German national nosocomial infection surveillance system from the period January 1997 through June 2008 were used. CVC-associated BSI data and SSI data were analyzed for 3 starting periods, and VAP data were analyzed for 2 starting periods. Monthly infection rates were calculated for the following 36 months, and relative risks comparing the first and third surveillance years of each period were calculated.Results.A total of 2,399 CVC-associated BSI cases from 267 intensive care units, 3,637 VAP cases from 150 intensive care units, and 829 SSIs following 3 different procedures from 113 departments were analyzed. A significant reduction in VAP was shown for both starting periods investigated (overall relative risk [RR], 0.80 [95% CI, 0.74-0.86]). A significant reduction in CVC-associated BSI was demonstrated for 2 of 3 starting periods (overall RR, 0.83 [95% CI, 0.75-0.91]). A significant reduction in SSI was found for 2 starting periods for knee prosthesis insertion (overall RR, 0.56 [95% CI, 0.38-0.82]), for all of the 3 starting periods for cesarean delivery (overall RR, 0.75 [95% CI, 0.61-0.93]), and for none of the 3 starting periods for endoscopically performed cholecystectomy (overall RR, 0.89 [95% CI, 0.62-1.27]).Conclusions.The surveillance effect, manifest as a significant reduction of nosocomial infection rates between the first and third years of participation in a surveillance system, was observed independently from the calendar year in which the surveillance activities started.

scholarly journals Nosocomial Infection Rates in an Italian Intensive Care Unit Using the National Nosocomial Infection Surveillance System

2001 ◽  
Vol 22 (03) ◽  
pp. 132-133 ◽  
Author(s):  
Federico Pallavicini ◽  
Mariano Alberto Pennisi ◽  
Immacolata Izzi ◽  
Adriana Ammassari ◽  
Paolo Mazzini ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Surveillance System ◽  
National Nosocomial Infection Surveillance ◽  
Infection Rates ◽  
Infection Surveillance

scholarly journals Making a Case for Adjusting NHSN SSI Risk Stratification Classification for Use of Enhanced Electronic Infection Surveillance

2020 ◽  
Vol 41 (S1) ◽  
pp. s18-s18
Author(s):  
Meri Pearson ◽  
Krista Doline
Keyword(s):  
Healthcare System ◽  
Surveillance System ◽  
Hip Prosthesis ◽  
Knee Prosthesis ◽  
Surgical Site Infections ◽  
Detection Methods ◽  
Surveillance Systems ◽  
Electronic Surveillance ◽  
Healthcare Associated Infection ◽  
Infection Surveillance

Background: A large healthcare system in Georgia went live with an enhanced electronic infection surveillance system in August of 2018. The system was employed at its facilities using a staggered approach. Prior to the implementation of this infection surveillance platform, the healthcare system performed healthcare-associated infection (HAI) surveillance using an in-house culture-based system. The NHSN estimates that culture-based surveillance misses 50%–60% of true surgical site infections (SSIs). Due to the lack of clinical-based detection methods (eg, radiologic imaging), we were unable to appropriately detect all patient harm using the old surveillance system. Method: A retrospective analysis was performed to assess the change in HAI for colon (COLO), abdominal hysterectomy (HYST), hip prosthesis (HPRO), and knee prosthesis (KPRO). SSI cases that met NHSN surveillance criteria were reviewed to determine whether they would have been identified prior to launching the new enhanced electronic surveillance system. Results: Systemwide, 8 of 26 COLO SSIs (31%) and 9 of 18 HYST SSIs (50%) would have not been detected using our old surveillance system. HPRO SSIs and KPRO SSIs identified by our new surveillance system were detected using our old surveillance system, and no change was observed. Conclusion: This analysis showed an increase in COLO SSIs and HYST SSIs from enhanced surveillance. Electronic surveillance systems are not considered as a risk factor in the NHSN annual facility survey that aids in calculating a facility’s standardized infection ratio (SIR). These data help support NHSN consideration of modifying the logistic regression calculation used for the complex SSI models. This revision would allow facilities to compare themselves equitably to those using electronic infection surveillance.Funding: NoneDisclosures: None

scholarly journals Infecção de sítio cirúrgico: estudo prospectivo de 2.149 pacientes operados

1999 ◽  
Vol 26 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Francisco Ney Lemos ◽  
Adriano Veras Oliveira ◽  
Maria Geciliane de Sousa
Keyword(s):  
Nosocomial Infection ◽  
Surveillance System ◽  
National Nosocomial Infection Surveillance ◽  
Infection Surveillance

A atual caracterização de infecção do sítio cirúrgico em incisional superficial, incisional profunda e órgão cavidade, em substituição à tradicional definição de "infecção de ferida operatória", associada a estratificação dos pacientes em grupos de risco de infecção cirúrgica de acordo com a metodologia NNISS (National Nosocomial Infection Surveillance System), permitiram a obtenção de taxas de infecção mais fidedignas e estudos comparativos entre instituições diferentes. Baseado nessa metodologia, o presente trabalho analisa prospectivamente 2.149 pacientes operados no Serviço de Cirurgia do Hospital Geral César Cals (HGCC)-CE, estratificados pelo IRIC (Índice de Risco de Infecção Cirúrgica) e comprova diferenças estatisticamente significativas nas taxas de infecção de sítio cirúrgico para os grupos de IRIC 0, 1,2 e 3, respectivamente de 3,2%, 7,4%, 16,6% e 20,9%. As infecções de maior gravidade ocorrem em pacientes com IRIC 3 e a vigilância pós-alta é importante, na medida em que muitas infecções somente serão diagnosticadas após a alta hospitalar.

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