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Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Published online by Cambridge University Press:  02 January 2015

Eu Suk Kim
Affiliation:
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Hong Bin Kim
Affiliation:
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Kyoung-Ho Song
Affiliation:
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Young Keun Kim
Affiliation:
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
Hyung-Ho Kim,
Affiliation:
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
Hye Young Jin
Affiliation:
Infection Control Office, Ajou University Hospital, Suwon, Republic of Korea
Sun Young Jeong
Affiliation:
Infection Control Office, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
Joohon Sung
Affiliation:
Department of Epidemiology and Institute of Environment and Health, Seoul National University School of Public Health, Seoul, Republic of Korea
Yong Kyun Cho
Affiliation:
Division of Infectious Diseases, Gachon University Gil Hospital, Incheon, Republic of Korea
Yeong-Seon Lee
Affiliation:
Center for Infectious Diseases, Korea National Institute of Health, Osong, Republic of Korea
Hee-Bok Oh
Affiliation:
Center for Infectious Diseases, Korea National Institute of Health, Osong, Republic of Korea
Eui-Chong Kim
Affiliation:
Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
June Myung Kim
Affiliation:
Division of Infectious Diseases, Yonsei Medical Center, Seoul, Republic of Korea
Tae Yeol Choi
Affiliation:
Department of Laboratory Medicine, Hanyang University Hospital, Seoul, Republic of Korea
Hee Jung Choi
Affiliation:
Department of Internal Medicine, Ewha Womans University, School of Medicine, Seoul, Republic of Korea
Hyo Youl Kim*
Affiliation:
Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
*
Division of Infectious Diseases, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 162, Ilsan-dong, Wonju, Gangwon-do, 220–701, Republic of Korea, (hyksos@yonsei.ac.kr)
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Abstract

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Objective.

To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.

Design.

A nationwide prospective multicenter study.

Setting.

Twenty university-affiliated hospitals in Korea.

Methods.

The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.

Results.

Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 (±12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09–2.58]), increased operation time (1.20 [1.07–1.34] per 1-hour increase), reoperation (7.27 [3.68–14.38]), combined multiple procedures (1.79 [1.13–2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09–8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26–5.64]) were independently associated with increased risk of SSI.

Conclusions.

Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

Footnotes

a.

These authors contributed equally to this work.

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