scholarly journals 881. Efficacy of Antibiotic Prophylaxis with Vancomycin in Cardiothoracic Surgery

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S477-S477
Author(s):  
Margaret Cooper ◽  
Jing Zhao
Keyword(s):  
Primary Outcome ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Medical Center ◽  
Surgical Site Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
High Incidence ◽  
The Difference ◽  
Gram Negative Organisms ◽  
Discernible Difference

Abstract Background Due to the high incidence of methicillin-resistant Staphylococcus aureus (MRSA) at the Detroit Medical Center, vancomycin is now routinely part of the prophylaxis regimen for cardiothoracic (CT) surgery. The study aims to compare the rate and types of surgical site infections (SSIs) when vancomycin is added to cefazolin for CT surgery compared to cefazolin alone. Methods This was a retrospective cohort study conducted at two university-affiliated hospitals. Patients who underwent CT surgery between January 2008 and August 2017 and had a readmission for SSI within 90 days of procedure were included. Patients who received cefazolin were compared to patients who received both cefazolin and vancomycin for CT surgery prophylaxis. The primary outcome was incidence of SSIs within 90 days of surgery as defined by the Centers for Disease Control and National Healthcare Safety Network. Results Out of 828 patients who underwent CT surgeries, there were 32 patients readmitted within 90 days for SSI. SSI occurred in 4.7% of patients who received cefazolin monotherapy, and 2.4% of patients who received both cefazolin and vancomycin (p=0.095). There was no discernible difference in types of SSI between groups. Pathogens were isolated in 78% of SSIs, with 75% Gram-positive and 19% Gram-negative organisms. SSIs resulted in an average 9.8 days in the hospital and 28.9 days of antibiotic therapy, and led to a total of 15 additional procedures. Conclusion Vancomycin added to cefazolin for prophylaxis in CT surgery resulted in lower incidence of SSI, however the difference was not statistically significant. Disclosures All Authors: No reported disclosures

scholarly journals Surveying the Surveillance: Surgical Site Infections Excluded by the January 2013 Updated Surveillance Definitions

2014 ◽  
Vol 35 (5) ◽  
pp. 570-573 ◽  
Author(s):  
Kristen V. Dicks ◽  
Sarah S. Lewis ◽  
Michael J. Durkin ◽  
Arthur W. Baker ◽  
Rebekah W. Moehring ◽  
...  
Keyword(s):  
Disease Control ◽  
Surgical Site Infections ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Control And Prevention ◽  
Centers For Disease Control

The updated 2013 Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for surgical site infections (SSIs) reduced the duration of prolonged surveillance from 1 year to 90 days and defined which procedure types require prolonged surveillance. Applying the updated 2013 SSI definitions to cases analyzed using the pre-2013 surveillance definitions excluded 10% of previously identified SSIs.

scholarly journals The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network

2021 ◽  
pp. 1-14 ◽  
Author(s):  
Lindsey M. Weiner-Lastinger ◽  
Vaishnavi Pattabiraman ◽  
Rebecca Y. Konnor ◽  
Prachi R. Patel ◽  
Emily Wong ◽  
...  
Keyword(s):  
State Level ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Tract Infections ◽  
Healthcare Associated ◽  
The Impact

Abstract Objectives: To determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on healthcare-associated infection (HAI) incidence in US hospitals, national- and state-level standardized infection ratios (SIRs) were calculated for each quarter in 2020 and compared to those from 2019. Methods: Central–line–associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), ventilator-associated events (VAEs), select surgical site infections, and Clostridioides difficile and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia laboratory-identified events reported to the National Healthcare Safety Network for 2019 and 2020 by acute-care hospitals were analyzed. SIRs were calculated for each HAI and quarter by dividing the number of reported infections by the number of predicted infections, calculated using 2015 national baseline data. Percentage changes between 2019 and 2020 SIRs were calculated. Supporting analyses, such as an assessment of device utilization in 2020 compared to 2019, were also performed. Results: Significant increases in the national SIRs for CLABSI, CAUTI, VAE, and MRSA bacteremia were observed in 2020. Changes in the SIR varied by quarter and state. The largest increase was observed for CLABSI, and significant increases in VAE incidence and ventilator utilization were seen across all 4 quarters of 2020. Conclusions: This report provides a national view of the increases in HAI incidence in 2020. These data highlight the need to return to conventional infection prevention and control practices and build resiliency in these programs to withstand future pandemics.

scholarly journals Clinical implications of restrictions in criteria for defining surgical site infections after mastectomy

2020 ◽  
pp. 1-3
Author(s):  
Antoinette A. A. Bediako-Bowan ◽  
David K. Warren ◽  
Katelin B. Nickel ◽  
Victoria J. Fraser ◽  
Margaret A. Olsen
Keyword(s):  
Surgical Site Infection ◽  
Surgical Site Infections ◽  
Adverse Outcomes ◽  
Clinical Implications ◽  
Site Infection ◽  
National Healthcare ◽  
National Healthcare Safety Network

Abstract More than 50% of women with clinically apparent infection after mastectomy did not meet the 2020 National Healthcare Safety Network (NHSN) definition for surgical site infection (SSI). Implant loss was similar whether the 2020 NHSN SSI definition was met or not, suggesting equivalent adverse outcomes regardless of restriction to the surveillance definition.

Surgical Site Infections Following Pediatric Ambulatory Surgery: An Epidemiologic Analysis

2016 ◽  
Vol 37 (8) ◽  
pp. 931-938 ◽  
Author(s):  
Michael L. Rinke ◽  
Dominique Jan ◽  
Janelle Nassim ◽  
Jaeun Choi ◽  
Steven J. Choi
Keyword(s):  
Risk Factors ◽  
Sensitivity And Specificity ◽  
Random Sampling ◽  
Ambulatory Surgery ◽  
Care Center ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Systematic Random Sampling ◽  
National Healthcare ◽  
National Healthcare Safety Network

OBJECTIVETo identify surgical site infection (SSI) rates following pediatric ambulatory surgery, SSI outcomes and risk factors, and sensitivity and specificity of SSI administrative billing codes.DESIGNRetrospective chart review of pediatric ambulatory surgeries with International Classification of Disease, Ninth Revision (ICD-9) codes for SSI, and a systematic random sampling of 5% of surgeries without SSI ICD-9 codes, all adjudicated for SSI on the basis of an ambulatory-adapted National Healthcare Safety Network definition.SETTINGUrban pediatric tertiary care center April 1, 2009-March 31, 2014.METHODSSSI rates and sensitivity and specificity of ICD-9 codes were estimated using sampling design, and risk factors were analyzed in case–rest of cohort, and case-control, designs.RESULTSIn 15,448 pediatric ambulatory surgeries, 34 patients had ICD-9 codes for SSI and 25 met the adapted National Healthcare Safety Network criteria. One additional SSI was identified with systematic random sampling. The SSI rate following pediatric ambulatory surgery was 2.9 per 1,000 surgeries (95% CI, 1.2–6.9). Otolaryngology surgeries demonstrated significantly lower SSI rates compared with endocrine (P=.001), integumentary (P=.001), male genital (P<.0001), and respiratory (P=.01) surgeries. Almost half of patients with an SSI were admitted, 88% received antibiotics, and 15% returned to the operating room. No risk factors were associated with SSI. The sensitivity of ICD-9 codes for SSI following ambulatory surgery was 55.31% (95% CI, 12.69%–91.33%) and specificity was 99.94% (99.89%–99.97%).CONCLUSIONSSSI following pediatric ambulatory surgery occurs at an appreciable rate and conveys morbidity on children.Infect Control Hosp Epidemiol 2016;37:931–938

Evaluation of the reliability of MRSA screens in patients undergoing universal decolonization

2020 ◽  
Vol 77 (23) ◽  
pp. 1965-1972
Author(s):  
Amna Chaudhry ◽  
Bryan Allen ◽  
Meagan Paylor ◽  
Sarah Hayes
Keyword(s):  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Primary Outcome ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Pulmonary Infections ◽  
Before And After ◽  
Intranasal Mupirocin ◽  
Mrsa Infection ◽  
Secondary Outcomes ◽  
The Difference

Abstract Purpose Colonization of methicillin-resistant Staphylococcus aureus (MRSA) can be detected via nasal screens. Evidence indicates that negative MRSA nasal screens may be used to de-escalate anti-MRSA antibiotics in pulmonary infections. In the ICU, universal decolonization with intranasal mupirocin is implemented to reduce MRSA infection risk. This study aimed to determine whether mupirocin administration affects the reliability of MRSA PCR nasal screens. Methods This retrospective study divided subjects based on timing of intranasal mupirocin administration—before and after MRSA screen. Subjects with confirmed pulmonary infection that received vancomycin, blood/respiratory cultures, and had MRSA PCR screen collected were included. Subjects with concurrent infection requiring vancomycin or MRSA infection in prior 30 days were excluded. Primary outcome of this non-inferiority study was the negative predictive value (NPV) of the screen. Secondary outcomes included the positive predictive value (PPV), sensitivity, and specificity of the screen and duration of vancomycin. Results Ultimately, 125 subjects were included in each group. The NPV in the group receiving mupirocin before screen was 95.2%, whereas the NPV in the group receiving mupirocin after screen was 99%. The difference between groups was -3.8% (90% CI -7.8%-0.2%; p=0.31), which failed to meet non-inferiority criteria. The secondary outcomes of PPV, sensitivity and specificity of the screen were similar in both groups. The duration of vancomycin was significantly longer in subjects receiving mupirocin before screen (3 days vs. 2 days; p&lt;0.05). Conclusion Intranasal mupirocin prior to the screen may reduce NPV in pulmonary infections. Approach de-escalation of vancomycin based on screen results with caution.

Performance of simplified surgical site infection (SSI) surveillance case definitions for resource limited settings: Comparison to SSI cases reported to the National Healthcare Safety Network, 2013–2017

2020 ◽  
Vol 41 (5) ◽  
pp. 611-613
Author(s):  
Matthew D. Westercamp ◽  
Margaret A. Dudeck ◽  
Kathy Allen-Bridson ◽  
Rebecca Konnor ◽  
Jonathan R. Edwards ◽  
...  
Keyword(s):  
Surgical Site Infections ◽  
Healthcare Associated Infections ◽  
Reference Standard ◽  
Case Definitions ◽  
Middle Income ◽  
Middle Income Countries ◽  
National Healthcare ◽  
National Healthcare Safety Network ◽  
Resource Limited ◽  
Healthcare Associated

AbstractSurgical site infections (SSIs) are among the most common healthcare-associated infections in low- and middle-income countries. To encourage establishment of actionable and standardized SSI surveillance in these countries, we propose simplified surveillance case definitions. Here, we use NHSN reports to explore concordance of these simplified definitions to NHSN as ‘reference standard.’

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