Preliminary data from a surveillance study on surgical site infections and assessment of risk factors in a university hospital

Surgical site infections (SSIs) lead to substantial mortality, morbidity, and socioeconomic loss. To explore the rate of infections and risk factors for the development of infection in surgical units. Materials and methods: All patients (n = 1397) who underwent a surgical intervention and were hospitalized for >48 h in surgical units (except the ophthalmology unit) of Gaziantep University Medical Faculty Hospital between 17 March 2008 and 15 July 2008 were included in the study. The Center for Disease Control and Prevention criteria were used for identifying and diagnosing SSIs. Rate of SSI was calculated as the number of SSIs observed after every 100 surgical procedures. Potential risk factors for SSIs were evaluated by multivariate logistic regression model. Results: SSIs occurred in 131 (9.4%) of the 1397 patients during this period. SSIs extended length of stay by 12.8 days. In the multivariate logistic regression analysis, diabetes mellitus (OR: 2.660, CI: 1.389-5.093), use of surgical drains (OR: 3.706, CI: 1.910-7.191), perioperative transfusion (OR: 1.787, CI: 1.077-2.965), trauma (OR: 2.244, CI: 1032-4.880), reoperation (OR: 7.408, CI: 3.315-16.555), contaminated (OR: 3.291, CI: 1.433-7.556) or dirty-infected (OR: 3.451, CI: 1.888-6.310) wound types, and each point increase in the National Nosocomial Infection Surveillance (NNIS) risk index (OR: 7.499, CI: 4.336-12.967) were detected as independent risk factors for developing SSIs. Conclusion: In an effort to decrease SSI rate, risk factors should be determined and essential measures should be implemented regarding preventable factors. In this context, the excess transfusion of blood and blood products and unnecessary use of surgical drains should be avoided, and surgical drains should be removed as soon as possible. In addition, traditional wound classification and NNIS risk index may be used in the prediction of SSIs.

Preliminary data from a surveillance study on surgical site infections and assessment of risk factors in a university hospital

Surgical site infections (SSIs) lead to substantial mortality, morbidity, and socioeconomic loss. To explore the rate of infections and risk factors for the development of infection in surgical units. Materials and methods: All patients (n = 1397) who underwent a surgical intervention and were hospitalized for >48 h in surgical units (except the ophthalmology unit) of Gaziantep University Medical Faculty Hospital between 17 March 2008 and 15 July 2008 were included in the study. The Center for Disease Control and Prevention criteria were used for identifying and diagnosing SSIs. Rate of SSI was calculated as the number of SSIs observed after every 100 surgical procedures. Potential risk factors for SSIs were evaluated by multivariate logistic regression model. Results: SSIs occurred in 131 (9.4%) of the 1397 patients during this period. SSIs extended length of stay by 12.8 days. In the multivariate logistic regression analysis, diabetes mellitus (OR: 2.660, CI: 1.389-5.093), use of surgical drains (OR: 3.706, CI: 1.910-7.191), perioperative transfusion (OR: 1.787, CI: 1.077-2.965), trauma (OR: 2.244, CI: 1032-4.880), reoperation (OR: 7.408, CI: 3.315-16.555), contaminated (OR: 3.291, CI: 1.433-7.556) or dirty-infected (OR: 3.451, CI: 1.888-6.310) wound types, and each point increase in the National Nosocomial Infection Surveillance (NNIS) risk index (OR: 7.499, CI: 4.336-12.967) were detected as independent risk factors for developing SSIs. Conclusion: In an effort to decrease SSI rate, risk factors should be determined and essential measures should be implemented regarding preventable factors. In this context, the excess transfusion of blood and blood products and unnecessary use of surgical drains should be avoided, and surgical drains should be removed as soon as possible. In addition, traditional wound classification and NNIS risk index may be used in the prediction of SSIs.

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  • Clean-contaminated 0.920 052 0.391–2.830 Contaminated 0.005 291 433–7.556 Dirty-infected 451 888–6.310 NNIS risk index (reference –1) 499 336–12.967 Nichols RL. Surgical wound infection. In: Bennett JV, Brachman PS, Eds. Hospital infections. 4th edn. Philadelphia: Lippincott-Raven, 1998: p.909–15.
  • Nichols RL. Prevention surgical site infections: A surgeon’s perspective. Emerg Infect Dis 2001; 7: 220–224. de Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 2009; 37: 387–97.
  • Haley RW, Culver DH, White JW, Morgan WM, Emori TG, Munn VP et al. The efficacy of surveillance and control programs in preventing nosocomial infection in US hospitals. Am J Epidemiol 1985; 121: 182–250.
  • Howard RJ. Surgical infections. In: Schwartz SI., Eds. Principles of Surgery, 7th ed, New York: McGraw-Hill, 1999: p.123–153.
  • Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999; 20: 247–278.
  • Geyik MF, Hoşoğlu S, Ayaz C, Çelen MK, Üstün. Surveillance of nosocomial infections in Dicle University Hospital: a tenyear experience. Turk J Med Sci 2008; 38: 587–593.
  • İncecik Ş, Saltoğlu N, Yaman A, Karayaylalı İ, Özalevli M, Gündüz M et al. The problem of antimicrobial resistance in nosocomial medical and surgical intensive care units infections in a university hospital; a two-year prospective study. Turk J Med Sci 2009; 39: 295–304.
  • Kaya E, Yetim I, Dervişoğlu A, Sünbül M, Bek Y. Risk factors for and effect of a one-year surveillance program on surgical site infection at a university hospital in Turkey. Surg Infect 2006; 7: 519–526.
  • Topaloğlu S, Akin M, Avsar FM, Ozel H, Polat E, Akin T et al. Correlation of risk and postoperative assessment methods in wound surveillance. J Surg Res 2008; 15; 146: 211–217.
  • Gaynes RP, Culver DH, Horan TC, Edwards JR, Richards C, Tolson JS. Surgical site infection (SSI) rates in the United States, 1992–1998: the National Nosocomial Infection Surveillance System basic SSI risk index. Clin Infect Dis 2001; 33: 69–77.
  • Jodra VM, Diaz-Agero Perez C, Sainz de Los Terreros Soler L, Saa Requejo CM, Dacosta Bellesteros D, Quality Control Indicator Working Group. Results of the Spanish national nosocomial infection surveillance network (VICONOS) for surgery patients from January 1997 through December 2003. Am J Infect Control 2006; 34: 134–141.
  • Astagneau P, Rioux C, Golliot F, Brücker G; INCISO Network Study Group. Morbidity and mortality associated with surgical site infections: results from the 1997–1999 INCISO surveillance. J Hosp Infect 2001; 48: 267–274.
  • Pryor F, Messmer PR. The effect of traffic patterns in the OR on surgical site infections. AORN J 1998; 68: 649–660.
  • Petrosillo N, Drapeau C, Nicastri E, Martini L, Ippolito G, Moro ML, ANIPIO. Surgical site infections in Italian hospitals: a prospective multicenter study. BMC Infectious Diseases 2008; 8: 1–9.
  • Roumbelaki M, Kritsotakis EI, Tsioutis C, Tzilepi P, Gikas A. Surveillance of surgical site infections at tertiary care hospital in Greece: incidence, risk factors, microbiology and impact. Am J Infect Control 2008; 36: 732–738.
  • Malone DL, Genuit T, Tracy JK, Gannon C, Napolitano LM. Surgical site infections: reanalysis of risk factors. J Surg Res 2002; 103: 89–95.
  • Pessaux P, Msika S, Atalla D, Hay JM, Flamant Y. Risk factors for postoperative infectious complications in noncolorectal abdominal surgery: a multivariate analysis based on a prospective multicenter study of 4718 patients. Arch Surg 2003; 138: 314–324.
  • Hill GE, Frawley WH, Griffith KE, Forestner JE, Minei JP. Allogeneic blood transfusion increases the risk of postoperative bacterial infections: a meta-analysis. J Trauma 2003; 54: 908– 9
  • Sohn AH, Parvez FM, Vu T, Hai HH, Bich NN, Le Thu TA et al. Prevalence of surgical-site infections and patterns of antimicrobial use in a large tertiary-care hospital in Ho Chi Minh City, Vietnam. Infect Control Hosp Epidemiol 2002; 23: 382–387.
  • Lepelletier D, Perron S, Bizouarn P, Caillon J, Drugeon H, Michaud JL et al. Surgical-site infection after cardiac surgery: incidence, microbiology, and risk factors. Infect Control Hosp Epidemiol. 2005; 26: 466–472.
  • Kasatpibal N, Jamulitrat S, Chongsuvivatwong V. Standardized incidence rates of surgical site infection: a multicenter study in Thailand. Am J Infect Control 2005; 33: 587–594.
  • Bundy JK, Gonzalez VR, Barnard BM, Hardy RJ, DuPont HL. Gender risk differences for surgical site infections among a primary coronary artery bypass graft surgery cohort: 199519 Am J Infect Control 2006; 34: 114–121.
  • Narong MN, Thongpiyapoom S, Thaikul N, Jamulitrat S, Kasatpibal N. Surgical site infections in patients undergoing major operations in a university hospital: using standardized infection ratio as a benchmarking tool. Am J Infect Control 2003; 31: 274–279.
  • Friedman ND, Bull AL, Russo PL, Gurrin L, Richards M. Performance of the national nosocomial infections surveillance risk index in predicting surgical site infection in Australia. Infect Control Hosp Epidemiol 2007; 28: 55–59.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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