Effect of Preoperative Antibiotic Prophylaxis on Surgical Site Infections Complicating Cardiac Surgery

2014 ◽  
Vol 35 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Renato Finkelstein ◽  
Galit Rabino ◽  
Tania Mashiach ◽  
Yaron Bar-El ◽  
Zvi Adler ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Antibiotic Prophylaxis ◽  
Medical Center ◽  
Surgical Site Infections ◽  
Control Program ◽  
Risk Category ◽  
Infection Control Program ◽  
Preoperative Antibiotic Prophylaxis ◽  
Preoperative Hospital Stay ◽  
Preoperative Prophylaxis

Objective.To evaluate the effect of an optimized policy for antibiotic prophylaxis on surgical site infection (SSI) rates in cardiac surgery.Design.Prospective cohort study.Setting.Tertiary medical center in Israel.Methods.SSIs were recorded during a 10-year study period and ascertained through routine surveillance using the National Healthcare Safety Network (NHSN) methodology. Multivariable analyses were conducted to determine which significant covariates, including the administration of preoperative prophylaxis, affected these outcomes.Results.A total of 2,637 of 3,170 evaluated patients were included, and the overall SSI rate was 8.4%. A greater than 50% reduction in SSI rates was observed in the last 4 years of the study. Overall and site-specific infection rates were similar for patients receiving cefazolin or vancomycin. SSIs developed in 206 (8.1%) of the 2,536 patients who received preoperative prophylaxis (within 2 hours of the first incision) compared with 14 (13.9%) of 101 patients who received antibiotic prophylaxis at a different time (P= .04; odds ratio [OR], 1.8; 95% confidence interval [CI], 1.0–3.3). After accounting for covariates, preoperative hospital stay (5 days or more), an NHSN risk category (2 or 3), age (60 years or more), surgeon's role, and the period of measurement were significantly associated with SSIs. Emergency surgery, age, surgeon's role, and nonpreoperative prophylaxis were found to be independent predictors of superficial SSI.Conclusions.We observed a progressive and significant decrease in SSI rates after the implementation of an infection control program that included an optimized policy of preoperative prophylaxis in cardiac surgery.

scholarly journals Reduction of deep surgical site infections in cardiac surgery by introducing a multimodal infection control program

Critical Care ◽  
2015 ◽  
Vol 19 (Suppl 1) ◽  
pp. P79
Author(s):  
A Rutten ◽  
JP Ory ◽  
L Jamaer ◽  
A Van Assche ◽  
J Dubois
Keyword(s):  
Cardiac Surgery ◽  
Infection Control ◽  
Surgical Site Infections ◽  
Control Program ◽  
Infection Control Program

Prevention of Infections Associated With Permanent Cardiac Antiarrhythmic Devices by Implementation of a Comprehensive Infection Control Program

2004 ◽  
Vol 25 (6) ◽  
pp. 492-497 ◽  
Author(s):  
Abraham Borer ◽  
Jacob Gilad ◽  
Eytan Hyam ◽  
Francisc Schlaeffer ◽  
Pnina Schlaeffer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Infection Control ◽  
Medical Center ◽  
Tertiary Care ◽  
Pacemaker Implantation ◽  
Relative Weight ◽  
Control Program ◽  
Cardiac Device ◽  
Infection Control Program

AbstractObjective:To implement a comprehensive infection control (IC) program for prevention of cardiac device-associated infections (CDIs).Design:Prospective before-after trial with 2 years of follow-up.Setting:A tertiary-care, university-affiliated medical center.Patients:A consecutive sample of all adults undergoing cardiac device implantation between 1997 and 2002.Intervention:An IC program was implemented during late 2001 and included staff education, preoperative modification of patient risk factors, intraoperative control of strict aseptic technique, surgical scrubbing and attire, control of environmental risk factors, optimization of antibiotic prophylaxis, postoperative wound care, and active surveillance. The clinical endpoint was CDI rates.Results:Between 1997 and 2000, there were 7 CDIs among 725 procedures (mean annual CDI incidence, 1%). During the first 9 months of 2001, there were 7 CDIs among 167 procedures (4.2%; P = .007): CDIs increased from 7 among 576 to 3 among 124 following pacemaker implantation (P = .39) and from 0 among 149 to 4 among 43 following cardioverter-defibrillator implantation (P = .002). Of the 14 CDIs, 5 involved superficial wounds, 7 involved deep wounds, and 2 involved endocarditis. Following intervention, there were no cases of CDI among 316 procedures during 24 months of follow-up (4.2% reduction; P = .0005).Conclusions:We observed a high CDI rate associated with substantial morbidity. IC measures had an impact on CDI. Although the relative weight of each measure in the prevention of CDI remains unknown, our results suggest that implementation of a comprehensive IC program is feasible and efficacious in this setting.

scholarly journals The scope of a weekly infection control team rounding in an acute-care teaching hospital: a pilot study

2020 ◽  
Author(s):  
Yeon Su Jeong ◽  
Jin Hwa Kim ◽  
Seungju Lee ◽  
So Young Lee ◽  
Sun Mi Oh ◽  
...  
Keyword(s):  
Infection Control ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Essential Element ◽  
Surgical Site Infections ◽  
Control Program ◽  
Real Field ◽  
Care Hospital ◽  
Infection Control Program ◽  
Functional Coverage

Abstract Activities of infection control and prevention are diverse and complicated. Regular and well-organized inspection of infection control is essential element of infection control program. The aim of study was to identify strong points and limitations of weekly infection control rounding (ICTR) in an acute care hospital. We conducted infection control rounding weekly to improve the compliance of infection control in the real field at a 734-bed academic hospital in Republic of Korea between January, 18, 2018 to December, 26, 2018. We investigated the functional coverage of a weekly ICTR. The result of the rounding are categorized well maintained, improvement is needed, long-term support such as space or manpower is needed, not applicable and could not observed. ICTR visited median 7 times [interquartile range (IQR) 6–7 times] per department. When visiting a department, ICTR observed median 16 practices (IQR 12–22). There were 7452 results of practices. Of those results, 75% were monitored properly, 22% were not applicable, and 4% were difficult-to-observe. Among applicable practice results, the most common practices that were difficult to observe were strategies to prevent catheter-related surgical site infections and pneumonia, injection safety practices, and strategies to prevent occupationally-acquired infections. The ICTR was able to maintain regular visits to each department; however, additional observation is necessary to eliminate blind spots.* These authors contributed equally

Results of a Comprehensive Infection Control Program for Reducing Surgical-Site Infections in Coronary Artery Bypass Surgery

1999 ◽  
Vol 20 (8) ◽  
pp. 533-538 ◽  
Author(s):  
Samuel J. McConkey ◽  
Paul B. L'Ecuyer ◽  
Denise M. Murphy ◽  
Terry L. Leet ◽  
Thoralf M. Sundt ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Infection Control ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Surgical Site Infections ◽  
Control Program ◽  
Care Hospital ◽  
Infection Rates ◽  
Infection Control Program ◽  
Cabg Surgery

AbstractObjective:To evaluate the efficacy of a comprehensive infection control program on the reduction of surgical-site infections (SSIs) following coronary artery bypass graft (CABG) surgery.Design:Prospective cohort study.Setting:1,000-bed tertiary-care hospital.Patients:Persons undergoing CABG with or without concomitant valve surgery from April 1991 through December 1994.Interventions:Prospective surveillance, quarterly reporting of SSI rates, chlorhexidene showers, discontinuation of shaving, administration of antibiotic prophylaxis in the holding area, elimination of ice baths for cooling of cardioplegia solution, limitation of operating room traffic, minimization of flash sterilization, and elimination of postoperative tap-water wound bathing for 96 hours. Logistic regression models were fitted to assess infection rates over time, adjusting for severity of illness, surgeon, patient characteristics, and type of surgery.Results:2,231 procedures were performed. A reduction in infection rates was noted at all sites. The rate of deep chest infections decreased from 2.6% in 1991 to 1.6% in 1994. Over the same period, the rate of leg infections decreased from 6.8% to 2.7%, and of all SSI from 12.4% to 8.9%. The adjusted odds ratio (OR) for all SSIs for the end of 1994 compared to December 31,1991, was 0.37 (95% confidence interval [CI95], 0.22-0.63). For deep chest and mediastinal infections, the adjusted OR comparing the same period was 0.69 (CI95, 0.28-1.71).Conclusions:We observed significant reductions in SSI rates of deep and superficial sites in CABG surgery following implementation of a comprehensive infection control program. These differences remained significant when adjusted for potential confounding covariables

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