Surgical Site Infections Rates in More Than 13,000 Surgical Procedures in Three Cities in Peru: Findings of the International Nosocomial Infection Control Consortium

Objective.To report the results of a surveillance study on surgical site infections (SSIs) conducted by the International Nosocomial Infection Control Consortium (INICC).Design.Cohort prospective multinational multicenter surveillance study.Setting.Eighty-two hospitals of 66 cities in 30 countries (Argentina, Brazil, Colombia, Cuba, Dominican Republic, Egypt, Greece, India, Kosovo, Lebanon, Lithuania, Macedonia, Malaysia, Mexico, Morocco, Pakistan, Panama, Peru, Philippines, Poland, Salvador, Saudi Arabia, Serbia, Singapore, Slovakia, Sudan, Thailand, Turkey, Uruguay, and Vietnam) from 4 continents (America, Asia, Africa, and Europe).Patients.Patients undergoing surgical procedures (SPs) from January 2005 to December 2010.Methods.Data were gathered and recorded from patients hospitalized in INICC member hospitals by using the methods and definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) for SSI. SPs were classified into 31 types according toInternational Classification of Diseases, Ninth Revision, criteria.Results.We gathered data from 7,523 SSIs associated with 260,973 SPs. SSI rates were significantly higher for most SPs in INICC hospitals compared with CDC-NHSN data, including the rates of SSI after hip prosthesis (2.6% vs 1.3%; relative risk [RR], 2.06 [95% confidence interval (CI), 1.8–2.4];P<.001), coronary bypass with chest and donor incision (4.5% vs 2.9%; RR, 1.52 [95% CI, 1.4–1.6];P<.001); abdominal hysterectomy (2.7% vs 1.6%; RR, 1.66 [95% CI, 1.4–2.0];P<.001); exploratory abdominal surgery (4.1 % vs 2.0%; RR, 2.05 [95% CI, 1.6–2.6];P<.001); ventricular shunt, 12.9% vs 5.6% (RR, 2.3 [95% CI, 1.9–2.6];P<.001), and others.Conclusions.SSI rates were higher for most SPs in INICC hospitals compared with CDC-NHSN data.

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Administrative Coding Methods Impact Surgical Site Infection Rates

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.616 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s111-s112

Author(s):

Mohammed Alsuhaibani ◽

Mohammed Alzunitan ◽

Kyle Jenn ◽

Daniel Diekema ◽

Michael Edmond ◽

...

Keyword(s):

Cesarean Section ◽

Surgical Procedures ◽

Hip Prosthesis ◽

Knee Prosthesis ◽

Surgical Site Infections ◽

Fold Increase ◽

Abdominal Hysterectomy ◽

Absolute Difference ◽

Coding Method ◽

The Impact

Background: Surveillance for surgical site infections (SSI) is recommended by the CDC. Currently, colon and abdominal hysterectomy SSI rates are publicly available and impact hospital reimbursement. However, the CDC NHSN allows surgical procedures to be abstracted based on International Classification of Diseases, Tenth Revision (ICD-10) or current procedural terminology (CPT) codes. We assessed the impact of using ICD and/or CPT codes on the number of cases abstracted and SSI rates. Methods: We retrieved administrative codes (ICD and/or CPT) for procedures performed at the University of Iowa Hospitals & Clinics over 1 year: October 2018–September 2019. We included 10 procedure types: colon, hysterectomy, cesarean section, breast, cardiac, craniotomy, spinal fusion, laminectomy, hip prosthesis, and knee prosthesis surgeries. We then calculated the number of procedures that would be abstracted if we used different permutations in administration codes: (1) ICD codes only, (2) CPT codes only, (3) both ICD and CPT codes, and (4) at least 1 code from either ICD or CPT. We then calculated the impact on SSI rates based on any of the 4 coding permutations. Results: In total, 9,583 surgical procedures and 180 SSIs were detected during the study period using the fourth method (ICD or CPT codes). Denominators varied according to procedure type and coding method used. The number of procedures abstracted for breast surgery had a >10-fold difference if reported based on ICD only versus ICD or CPT codes (104 vs 1,109). Hip prosthesis had the lowest variation (638 vs 767). For SSI rates, cesarean section showed almost a 3-fold increment (2.6% when using ICD only to 7.32% with both ICD & CPT), whereas abdominal hysterectomy showed nearly a 2-fold increase (1.14% when using CPT only to 2.22% with both ICD & CPT codes). However, SSI rates remained fairly similar for craniotomy (0.14% absolute difference), hip prosthesis (0.24% absolute difference), and colon (0.09% absolute difference) despite differences in the number of abstracted procedures and coding methods. Conclusions: Denominators and SSI rates vary depending on the coding method used. Variations in the number of procedures abstracted and their subsequent impact on SSI rates were not predictable. Variations in coding methods used by hospitals could impact interhospital comparisons and benchmarking, potentially leading to disparities in public reporting and hospital penalties.Funding: NoneDisclosures: None

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Urgency of surgery as an indicator for the occurrence of surgical site infections: data from over 100,000 surgical procedures

Journal of Hospital Infection ◽

10.1016/j.jhin.2020.12.017 ◽

2021 ◽

Author(s):

Seven Johannes Sam Aghdassi ◽

Christin Schröder ◽

Petra Gastmeier

Keyword(s):

Surgical Procedures ◽

Surgical Site Infections

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An analysis of infection control of varicella-zoster virus infections in Addenbrooke's Hospital Cambridge over a 5-year period, 1987–92

Epidemiology and Infection ◽

10.1017/s0950268800001278 ◽

1996 ◽

Vol 117 (1) ◽

pp. 165-171 ◽

Cited By ~ 16

Author(s):

T. G. Wreghitt ◽

J. Whipp ◽

C. Redpath ◽

W. Hollingworth

Keyword(s):

Nosocomial Infection ◽

Infection Control ◽

Prospective Study ◽

Varicella Zoster Virus ◽

Virus Infections ◽

Patient Case ◽

Varicella Zoster ◽

Staff Members ◽

Spread Of Infection ◽

The Cost

SummaryThis prospective study analyses infections with varicella-zoster virus (VZV) in Addenbrooke's Hospital, Cambridge during 1987–92 and examines the spread of infection. In total, 93 patients and staff experienced VZV infection. Twenty-one patients had varicella and 49 experienced zoster. None of 101 patients and 1 of 625 staff members in contact with varicella cases acquired infection. By contrast, 2 of 227 patients, and 5 of 1039 staff in contact with zoster cases acquired varicella. One out of 28 (3·6%) VZV antibody-negative patients and staff in contact with varicella acquired infection, compared with 5 out of 29 (17·2%) VZV antibody-negative patients and staff in contact with zoster. Thus, zoster was found to be a more frequent cause of nosocomial infection than varicella. Fourteen members of staff had VZV infection during the study period. One of 99 patients and none of 389 staff members in contact with these cases developed varicella. The cost of dealing with infection control for VZV infections in our hospital is estimated to be £714 per patient case and a total of £13204 per year.

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Nosocomial Infection and Multidrug-Resistant Bacteria Surveillance in Intensive Care Units: A Survey in France

Infection Control and Hospital Epidemiology ◽

10.1086/502482 ◽

2005 ◽

Vol 26 (1) ◽

pp. 13-20 ◽

Cited By ~ 21

Author(s):

François L'Hériteau ◽

Corinne Alberti ◽

Yves Cohen ◽

Gilles Troché ◽

Pierre Moine ◽

...

Keyword(s):

Nosocomial Infection ◽

Infection Control ◽

Multiple Correspondence Analysis ◽

Venous Catheter ◽

Multidrug Resistant ◽

Resistant Bacteria ◽

Central Venous ◽

Venous Catheterization ◽

Structural Variables ◽

Tract Infections

AbstractObjectives:To evaluate nosocomial infection (NI) surveillance strategies in French ICUs and to identify similar patterns defining subsets within which comparisons can be made.Design:A questionnaire was sent to all French ICUs, and a random sample of nonresponders was interviewed.Participants:Three hundred ninety-five responder ICUs (69%) in France.Results:In 282 ICUs (71%), a dedicated ICU staff member was responsible for infection control activities. The microbiology laboratory was usually in the hospital (90%) and computerized (94%) but issued regular hospital microbiology records in only 48% of cases. Patients receiving mechanical ventilation, central venous catheterization, and urinary catheterization were 90%, 79%, and 60%, respectively. Patients were screened for carriage of mul-tidrug-resistant bacteria on admission and during the stay in 70% and 60% of ICUs, respectively, most often targeting MRSA. Quantitative cultures were used to diagnose ventilator-associated pneumonia (VAP) in 90% of ICUs, including distal specimens in 80% and bronchoscopy specimens in 60%. Quantitative central venous catheter (CVC)-segment cultures were used in 70% of ICUs. All CVCs were cultured routinely in 53% of the ICUs. Despite wide variations in infection control and surveillance strategies, multiple correspondence analysis identified 13 key points (4 structural variables and 9 variables concerning the diagnosis of VAP, the surveillance and diagnosis of catheter-related and urinary tract infections, and the mode of screening of MRSA carriers) that categorize the variability of French ICUs' approaches to NIs.Conclusion:This study revealed profound differences in N1 surveillance strategies across ICUs, indicating a need for caution when using N1 surveillance data for comparisons and benchmarking.

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