Factors Associated with Surgical Site Infection in Colorectal Surgery: The Japan Nosocomial Infections Surveillance

2014 ◽  
Vol 35 (6) ◽  
pp. 660-666 ◽  
Author(s):  
Keita Morikane ◽  
Hitoshi Honda ◽  
Takuya Yamagishi ◽  
Satowa Suzuki ◽  
Mayumi Aminaka
Keyword(s):  
Nosocomial Infections ◽  
Risk Index ◽  
Rectal Surgery ◽  
Emergency Operation ◽  
Healthcare Associated Infections ◽  
Colon And Rectal Surgery ◽  
Site Infection ◽  
Factors Associated ◽  
Male Sex ◽  
Healthcare Associated

Objective.Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). This study aims to assess factors associated with SSI after colorectal surgery in Japan, using a Japanese national database for HAIs.Design.A retrospective nationwide surveillance-based study.Setting.Japanese healthcare facilities.Methods.Data on colon and rectal surgeries performed from 2008 through 2010 were extracted from a national monitoring system for healthcare-associated infections, the Japan Nosocomial Infections Surveillance (JANIS). Factors associated with SSI after colon and rectal surgery were assessed using multivariate logistic regression.Results.The cumulative incidence of SSI for colon and rectal surgery was 15.0% (6,691 of 44,751) and 17.8% (3,230 of 18,187), respectively. Traditional risk factors included in the National Nosocomial Infections Surveillance (NNIS) modified risk index were significant in predicting SSI in the final model for both colon and rectal surgery. Among the additional variables routinely collected in JANIS were factors independently associated with the development of SSI, such as male sex (adjusted odds ratio [aOR], 1.20 [95% confidence interval (CI), 1.14–1.27]), ileostomy or colostomy placement (aOR, 1.13 [95% CI, 1.04–1.21]), emergency operation (aOR, 1.40 [95% CI, 1.29–1.52]), and multiple procedures (aOR, 1.22 [95% CI, 1.13–1.33]) for colon surgery as well as male sex (aOR, 1.43 [95% CI, 1.31–1.55]), ileostomy or colostomy placement (aOR, 1,63 [95% CI, 1.51–1.79]), and emergency operation (aOR, 1.43 [95% CI, 1.20–1.72]) for rectal surgery.Conclusions.For colorectal operations, inclusion of additional variables routinely collected in JANIS can more accurately predict SSI risk than can the NNIS risk index alone.Infect Control Hosp Epidemiol 2014;35(6):660–666

Factors Associated With Surgical Site Infection Following Gastric Surgery in Japan

2016 ◽  
Vol 37 (10) ◽  
pp. 1167-1172 ◽  
Author(s):  
Keita Morikane ◽  
Hitoshi Honda ◽  
Satowa Suzuki
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Emergency Operation ◽  
Hospital Performance ◽  
Gastric Surgery ◽  
National Database ◽  
Site Infection ◽  
Healthcare Facilities ◽  
Factors Associated ◽  
Healthcare Associated

BACKGROUNDSurgical site infection (SSI) following gastric surgery has not been well documented.OBJECTIVETo describe and assess factors associated with SSI following gastric surgery in Japan using a Japanese national database for healthcare-associated infections.DESIGNA retrospective nationwide surveillance-based study.SETTINGJapanese healthcare facilities.METHODSData on gastric surgeries performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance. Gastric surgery was divided into 3 types of procedures: total gastrectomy (GAST-T), distal gastrectomy (GAST-D), and other types of gastric surgery (GAST-O). The incidence of and factors associated with SSI following gastric surgery were assessed by the 3 types of procedures.RESULTSThe cumulative incidence of SSI following gastric surgery was 8.8% (3,156/36,052). The incidence of SSI following GAST-T (12.4%) was significantly higher than that following GAST-D (7.01%) or GAST-O (7.84%). Besides the 4 conventional risk factors for predicting SSI, additional risk factors were identified. Male sex was significantly associated with SSI following all types of gastric surgery, but the effect of the association was substantially different (adjusted odds ratio, 1.52, 1.47, and 1.28 for GAST-T, GAST-D, and GAST-O, respectively). The effect of an emergency operation was similar. Age was also identified as a risk factor, but the most suitable modification of age as a variable differed.CONCLUSIONSThe incidence and factors associated with SSI following 3 types of gastric surgery differed. To accurately compare hospital performance in SSI prevention following gastric surgery, dividing surgical procedures in the surveillance system into 3 types should be considered.Infect Control Hosp Epidemiol 2016;1–6

scholarly journals Patients' Hand Hygiene at Home Predicts Their Hand Hygiene Practices in the Hospital

2014 ◽  
Vol 35 (5) ◽  
pp. 585-588 ◽  
Author(s):  
Anna Barker ◽  
Ajay Sethi ◽  
Emily Shulkin ◽  
Rachell Caniza ◽  
Sara Zerbel ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Intrinsic Value ◽  
Healthcare Associated Infections ◽  
Hospital Hygiene ◽  
Factors Associated ◽  
Hygiene Practices ◽  
Hospital Patients ◽  
Hospital Practices ◽  
Healthcare Associated ◽  
At Home

We examine factors associated with hand hygiene practices of hospital patients. Hygiene in the hospital decreased compared to that at home, and home practices were strongly associated with hospital practices. Understanding and leveraging the intrinsic value some patients associate with hand hygiene may be important for improving overall hospital hygiene and decreasing healthcare-associated infections.

scholarly journals Time-series modelling for the quantification of seasonality and forecasting antibiotic-resistant episodes: application to carbapenemase-producing Enterobacteriaceae episodes in France over 2010–20

2020 ◽  
Vol 76 (1) ◽  
pp. 226-232
Author(s):  
Jonathan Roux ◽  
Narimane Nekkab ◽  
Mélanie Colomb-Cotinat ◽  
Pascal Astagneau ◽  
Pascal Crépey
Keyword(s):  
Time Series ◽  
Prediction Interval ◽  
Healthcare Associated Infections ◽  
Antibiotic Resistant ◽  
Factors Associated ◽  
Time Series Modelling ◽  
Potential Factors ◽  
Healthcare Associated ◽  
The Impact ◽  
National Surveillance System

Abstract Background Carbapenemase-producing Enterobacteriaceae (CPE) cause resistant healthcare-associated infections that jeopardize healthcare systems and patient safety worldwide. The number of CPE episodes has been increasing in France since 2009, but the dynamics are still poorly understood. Objectives To use time-series modelling to describe the dynamics of CPE episodes from August 2010 to December 2016 and to forecast the evolution of CPE episodes for the 2017–20 period. Methods We used time series to analyse CPE episodes from August 2010 to November 2016 reported to the French national surveillance system. The impact of seasonality was quantified using seasonal-to-irregular ratios. Seven time-series models and three ensemble stacking models (average, convex and linear stacking) were assessed and compared with forecast CPE episodes during 2017–20. Results During 2010–16, 3559 CPE episodes were observed in France. Compared with the average yearly trend, we observed a 30% increase in the number of CPE episodes in the autumn. We noticed a 1 month lagged seasonality of non-imported episodes compared with imported episodes. Average stacking gave the best forecasts and predicted an increase during 2017–20 with a peak up to 345 CPE episodes (95% prediction interval = 124–1158, 80% prediction interval = 171–742) in September 2020. Conclusions The observed seasonality of CPE episodes sheds light on potential factors associated with the increased frequency of episodes, which need further investigation. Our model predicts that the number of CPE episodes will continue to rise in the coming years in France, mainly due to local dissemination, associated with bacterial carriage by patients in the community, which is becoming an immediate challenge with regard to outbreak control.

Evaluation of Factors Associated with Successful Matriculation to Colon and Rectal Surgery Fellowship

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Mackenzie L. Shindorf ◽  
Amy R. Copeland ◽  
Shreya Gupta ◽  
Seth M. Steinberg ◽  
Scott R. Steele ◽  
...  
Keyword(s):  
Rectal Surgery ◽  
Colon And Rectal Surgery ◽  
Factors Associated

scholarly journals COMPARATIVE RESEARCH OF TRAUMATIC INJURY OF OPEN HAND-ASSISTED LAPAROSCOPIC ANTERIOR RESECTION OF THE RECTUM

2015 ◽  
Vol 174 (1) ◽  
pp. 52-58
Author(s):  
A. G. Khitar’Yan ◽  
E. E. Glumov ◽  
K. S. Veliev ◽  
R. N. Zavgorodnyaya ◽  
M. E. Provotorov
Keyword(s):  
Anterior Resection ◽  
Traumatic Injury ◽  
Rectal Surgery ◽  
Pain Syndrome ◽  
Emergency Operation ◽  
Colon And Rectal Surgery ◽  
Laparoscopic Anterior Resection ◽  
Invasive Method ◽  
Laparoscopic Colon ◽  
Analysis Of Dynamics

The article made a comparative assessment of traumatic injury of open hand-assisted laparoscopic anterior resection of the rectum in lateral and spinal positions. The presented technique of hand-assisted laparoscopic colon and rectal surgery is simple. There are advantages in case of obesity presence (IMT more than 30 kg/m²), in significant shortening of the mesocolon and mesentery, high fixation of splenic flexure and intimate fixation of the spleen, in case of bad preparation of the bowels in partial intestinal obstruction or in case of emergency operation, big cancer size, expressed perifocal inflammation. A comparative analysis of dynamics of hormone stress content and metabolism (cortisol, adrenaline, thyrothrophic hormone) showed their expressed increase in blood during operation after traditional surgery. Less stressed reaction was noted after hand-assisted surgery, especially in overweight patients. An application of low invasive method allowed reduction of hemorrhage, pain syndrome, terms of patient’s activation and restoration of intestinal motility after operation.

Analysis of the incidence of newborn's healthcare associated infections and intrauterine infections in several maternity hospitals in Moscow

2019 ◽  
pp. 73-79
Author(s):  
M. V. Ivanova
Keyword(s):  
Russian Federation ◽  
Nosocomial Infections ◽  
Intrauterine Infection ◽  
Healthcare Associated Infections ◽  
Laboratory Confirmation ◽  
Maternity Hospitals ◽  
Significant Difference ◽  
The Russian Federation ◽  
Healthcare Associated ◽  
Intrauterine Infections

Purpose of the study. To estimate the incidence of newborn's healthcare associated infections (HAI) and intrauterine infections in the Russian Federation, Moscow and three maternity hospitals in Moscow. Materials and methods. The retrospective epidemiological analysis of neonates HAIs and intrauterine infections during 2008–2017 was performed in the Russian Federation and Moscow and during 2009–2017 in three maternity hospitals (MH) in Moscow. In this study the maternity hospitals would be known as MH № X01, № X02 and № X03. Also, in this study, the calculation and analysis of the proportion of cases of newborn's HAIs and intrauterine infections with laboratory confirmation were performed in Moscow's maternity hospitals. The data was selected from Form № 2 for the Russian Federation and Moscow. Also, the data of the maternity hospitals was drawn from the base of the Hygiene and Epidemiology Center in Moscow. The morbidity rate of HAIs and intrauterine infections of newborns was counted on 1,000 newborns. Microsoft Office Excel 2010 software packages were used for this purpose. The calculation of the increase / decrease rate was made by the method of least squares. Results. The incidence of intrauterine infections and HAIs of newborns in the Russian Federation, Moscow, and maternity hospitals is characterized by the next mutual trends – a significant dominance cases of intrauterine infections' over the cases of HAI, extremely irregular registration and distribution of the nosologies' proportion. Concerning to the dynamics of morbidity during 2009–2017 in maternity hospitals in Moscow, the HAIs newborn's incidence has tendency of decline, and intrauterine infections has considerable increase of the incidence. This consistent pattern is observed in all described maternity hospitals. The structure of the incidence in maternity hospitals is similar to each other. The leading diagnoses among intrauterine infections are intrauterine infection without a lesion and intrauterine pneumonia. The interest of other infections is about 1%. The proportion of cases with laboratory confirmation of the newborn's HAIs and intrauterine infections is extremely small. Besides that, there were identified some indirect signs of poor-quality registration of nosocomial infections. Conclusion. Significant difference in the number of cases of newborn's HAIs and intrauterine infections and their multidirectional incidence trends, once again point to the concealment of a part of nosocomial infections, under such diagnoses, as intrauterine infection without a lesion and intrauterine pneumonia. Laboratory confirmation of cases of HAIs and intrauterine infections in the maternity hospitals is carried out only by a small proportion of patients. Thereby, the incidence rates of HAIs of newborns and intrauterine infections in maternity hospitals in Moscow raise doubts about their reliability.

Performance of surgical site infection risk prediction models in colorectal surgery: external validity assessment from three European national surveillance networks

2019 ◽  
Vol 40 (9) ◽  
pp. 983-990 ◽  
Author(s):  
Rebecca Grant ◽  
Martine Aupee ◽  
Nicolas C. Buchs ◽  
Kristine Cooper ◽  
Marie-Christine Eisenring ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Risk Model ◽  
Rectal Surgery ◽  
Predictive Ability ◽  
Specific Model ◽  
Colon And Rectal Surgery ◽  
National Surveillance ◽  
Site Infection ◽  
Surveillance Networks ◽  
Routinely Collected Data

AbstractObjective:To assess the validity of multivariable models for predicting risk of surgical site infection (SSI) after colorectal surgery based on routinely collected data in national surveillance networks.Design:Retrospective analysis performed on 3 validation cohorts.Patients:Colorectal surgery patients in Switzerland, France, and England, 2007–2017.Methods:We determined calibration and discrimination (ie, area under the curve, AUC) of the COLA (contamination class, obesity, laparoscopy, American Society of Anesthesiologists [ASA]) multivariable risk model and the National Healthcare Safety Network (NHSN) multivariable risk model in each cohort. A new score was constructed based on multivariable analysis of the Swiss cohort following colorectal surgery, then based on colon and rectal surgery separately.Results:We included 40,813 patients who had undergone elective or emergency colorectal surgery to validate the COLA score, 45,216 patients to validate the NHSN colon and rectal surgery risk models, and 46,320 patients in the construction of a new predictive model. The COLA score’s predictive ability was poor, with AUC values of 0.64 (95% confidence interval [CI], 0.63–0.65), 0.62 (95% CI, 0.58–0.67), 0.60 (95% CI, 0.58–0.61) in the Swiss, French, and English cohorts, respectively. The NHSN colon-specific model (AUC, 0.61; 95% CI, 0.61–0.62) and the rectal surgery–specific model (AUC, 0.57; 95% CI, 0.53–0.61) showed limited predictive ability. The new predictive score showed poor predictive accuracy for colorectal surgery overall (AUC, 0.65; 95% CI, 0.64–0.66), for colon surgery (AUC, 0.65; 95% CI, 0.65–0.66), and for rectal surgery (AUC, 0.63; 95% CI, 0.60–0.66).Conclusion:Models based on routinely collected data in SSI surveillance networks poorly predict individual risk of SSI following colorectal surgery. Further models that include other more predictive variables could be developed and validated.

Accounting for Incomplete Postdischarge Follow-Up During Surveillance of Surgical Site Infection by Use of the National Nosocomial Infections Surveillance System's Risk Index

2009 ◽  
Vol 30 (5) ◽  
pp. 433-439 ◽  
Author(s):  
Fernando Martín Biscione ◽  
Renato Camargos Couto ◽  
Tânia M. G. Pedrosa
Keyword(s):  
Surgical Site Infection ◽  
Nosocomial Infections ◽  
Goodness Of Fit ◽  
Risk Index ◽  
Operative Procedures ◽  
Site Infection ◽  
Goodness Of Fit Test ◽  
Simple Method ◽  
Genitourinary System

Objective.We examined the usefulness of a simple method to account for incomplete postdischarge follow-up during surveillance of surgical site infection (SSI) by use of the National Nosocomial Infections Surveillance (NNIS) system's risk index.Design.Retrospective cohort study that used data prospectively collected from 1993 through 2006.Setting.Five private, nonuniversity healthcare facilities in Belo Horizonte, Brazil.Patients.Consecutive patients undergoing the following NNIS operative procedures: 20,981 operations on the genitourinary system, 11,930 abdominal hysterectomies, 7,696 herniorraphies, 6,002 cholecystectomies, and 6,892 laparotomies.Methods.For each operative procedure category, 2 SSI risk models were specified. First, a model based on the NNIS system's risk index variables was specified (hereafter referred to as the NNIS-based model). Second, a modified model (hereafter referred to as the modified NNIS-based model), which was also based on the NNIS system's risk index, was specified with a postdischarge surveillance indicator, which was assigned the value of 1 if the patient could be reached during follow-up and a value of 0 if the patient could not be reached. A formal comparison of the capabilities of the 2 models to assess the risk of SSI was conducted using measures of calibration (by use of the Pearson goodness-of-fit test) and discrimination (by use of receiver operating characteristic curves). Goodman-Kruskal correlations (G) were also calculated.Results.The rate of incomplete postdischarge follow-up varied between 29.8% for abdominal hysterectomies and 50.5% for cholecystectomies. The modified NNIS-based model for laparotomy did not show any significant benefit over the NNIS-based model in any measure. For all other operative procedures, the modified NNIS-based model showed a significantly improved discriminatory ability and higher G statistics, compared with the NNIS-based model, with no significant impairment in calibration, except if used to assess the risk of SSI after operations on the genitourinary system or after a cholecystectomy.Conclusions.Compared with the NNIS-based model, the modified NNIS-based model added potentially useful clinical information regarding most of the operative procedures. Further work is warranted to evaluate this method for accounting for incomplete postdischarge follow-up during surveillance of SSI.

scholarly journals Evaluating the clinical and economic burden of healthcare-associated infections during hospitalization for surgery in France

2013 ◽  
Vol 141 (12) ◽  
pp. 2473-2482 ◽  
Author(s):  
L. LAMARSALLE ◽  
B. HUNT ◽  
M. SCHAUF ◽  
K. SZWARCENSZTEIN ◽  
W. J. VALENTINE
Keyword(s):  
Infection Control ◽  
Economic Burden ◽  
Nosocomial Infections ◽  
Healthcare Providers ◽  
Length Of Hospital Stay ◽  
Healthcare Associated Infections ◽  
The European Union ◽  
Economic Burden Of Disease ◽  
Systèmes D’Information ◽  
Healthcare Associated

SUMMARYOver 4 million patients suffer nosocomial infections annually in the European Union. This study aimed to estimate the healthcare burden associated with healthcare-associated infections (HAIs) following surgery in France, and explore the potential impact of infection control strategies and interventions on the clinical and economic burden of disease. Data on the frequency of HAIs were gathered from the 2010 Programme de Médicalisation des Systèmes d'Information (PMSI), and cost data were taken from the 2009 Echelle Nationale de Coûts à Méthodologie Commune (ENCC). It was estimated that 3% of surgical procedures performed in 2010 in France resulted in infection, resulting in an annual cost of €57 892 715. Patients experiencing a HAI had a significantly increased mortality risk (4·15-fold) and an increased length of hospital stay (threefold). Scenario analysis in which HAI incidence following surgery was reduced by 8% (based on a study of the effectiveness of triclosan-coated sutures), suggested that, annually, 20 205 hospital days and €4 588 519 could be saved. Analyses of 20% and 30% reductions in incidence (based on an estimate of the number of preventable nosocomial infections) suggested that annual savings of €11 548 057 and €17 334 696, respectively, could be made. New infection control interventions which reduce HAI incidence during hospitalization for surgery have the potential to provide valuable cost savings to healthcare providers.

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