Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-25T04:28:33.423Z Has data issue: false hasContentIssue false
  • English
  • Français

Trends in the Incidence of Surgical Site Infection in The Netherlands

Published online by Cambridge University Press:  02 January 2015

Judith Manniën ,
Susan van den Hof ,
Jan Muilwijk ,
Peterhans J. van den Broek ,
Birgit van Benthem  and
Jan C. Wille
Judith Manniën*
Affiliation:
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Susan van den Hof
Affiliation:
KNCV Tuberculosis Foundation, The Hague, The Netherlands
Jan Muilwijk
Affiliation:
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Peterhans J. van den Broek
Affiliation:
Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
Birgit van Benthem
Affiliation:
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
Jan C. Wille
Affiliation:
Dutch Institute for Healthcare Improvement (CBO), Utrecht, The Netherlands
*
National Institute for Public Health and the Environment (RIVM), Postbak 75, PO Box 1, 3720 BA Bilthoven, The Netherlands (Judith.Mannien@rivm.nl)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective.

To evaluate the time trend in the surgical site infection (SSI) rate in relation to the duration of surveillance in The Netherlands.

Setting.

Forty-two hospitals that participated in the the Dutch national nosocomial surveillance network, which is known as PREZIES (Preventie van Ziekenhuisinfecties door Surveillance), and that registered at least 1 of the following 5 frequently performed surgical procedures for at least 3 years during the period from 1996 through 2006: mastectomy, colectomy, replacement of the head of the femur, total hip arthroplasty, or knee arthroplasty.

Methods.

Analyses were performed for each surgical procedure. The surveillance time to operation was stratified in consecutive 1-year periods, with the first year as reference. Multivariate logistic regression analysis was performed using a random coefficient model to adjust for random variation among hospitals. All models were adjusted for method of postdischarge surveillance.

Results.

The number of procedures varied from 3,031 for colectomy to 31,407 for total hip arthroplasty, and the SSI rate varied from 1.6% for knee arthroplasty to 12.2% for colectomy. For total hip arthroplasty, the SSI rate decreased significantly by 6% per year of surveillance (odds ratio [OR], 0.94 [95% confidence interval {CI}, 0.90–0.98]), indicating a 60% decrease after 10 years. Nonsignificant but substantial decreasing trends in the rate of SSI were found for replacement of the head of the femur (OR, 0.94 [95% CI, 0.88–1.00]) and for colectomy (OR, 0.92 [95% CI, 0.83–1.02]).

Conclusions.

Even though most decreasing trends in the SSI rate were not statistically significant, they were encouraging. To use limited resources as efficiently as possible, we would suggest switching the surveillance to another surgical procedure when the SSI rate for that particular procedure has decreased below the target rate.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 12 , December 2008 , pp. 1132 - 1138
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182–205.CrossRefGoogle ScholarPubMed
2. Gaynes, R, Richards, C, Edwards, J, et al. Feeding back surveillance data to prevent hospital-acquired infections. Emerg Infect Dis 2001;7:295–298.Google Scholar
3. Harbarth, S, Sax, H, Gastmeier, P. The preventable proportion of nosocomial infections: an overview of published reports. J Hosp Infect 2003;54:258–266.Google Scholar
4. Geubbels, EL, Mintjes-de Groot, AJ, van den Berg, JM, de Boer, AS. An operating surveillance system of surgical-site infections in The Netherlands: results of the PREZIES national surveillance network. Preventie van Ziekenhuisinfecties door Surveillance. Infect Control Hosp Epidemiol 2000;21:311–318.Google Scholar
5. PREZIES national network for the surveillance of nosocomial infections. Available at: http://www.prezies.nl. Accessed October 10, 2008.Google Scholar
6. Geubbels, EL, Nagelkerke, NJ, Mintjes-De Groot, AJ, Vandenbroucke-Grauls, CM, Grobbee, DE, De Boer, AS. Reduced risk of surgical site infections through surveillance in a network. Int J Qual Health Care 2006;18:127–133.Google Scholar
7. Manniën, J, Wille, JC, Snoeren, RL, van den Hof, S. Impact of postdischarge surveillance on surgical site infection rates for several surgical procedures: results from the nosocomial surveillance network in the Netherlands. Infect Control Hosp Epidemiol 2006;27:809–816.Google Scholar
8. Manniën, J, van der Zeeuw, AE, Wille, JC, van den Hof, S. Validation of surgical site infection surveillance in The Netherlands. Infect Control Hosp Epidemiol 2007;28:36–41.Google Scholar
9. Miettinen, OS. Missing data representation. In: Miettinen, OS. Theoretical Epidemiology: Principles of Occurrence Research in Medicine. New York: lohn Wiley and Sons; 1985:231–233.Google Scholar
10. Gastmeier, P, Sohr, D, Brandt, C, Eckmanns, T, Behnke, M, Rüden, H. Reduction of orthopaedic wound infections in 21 hospitals. Arch Orthop Trauma Surg 2005;125:526–530.CrossRefGoogle ScholarPubMed
11. Bärwolff, S, Sohr, D, Geffers, C, et al. Reduction of surgical site infections after Caesarean delivery using surveillance. J Hosp Infect 2006;64:156–161.CrossRefGoogle ScholarPubMed
12. Brandt, C, Sohr, D, Behnke, M, Daschner, F, Ruden, H, Gastmeier, P. Reduction of surgical site infection rates associated with active surveillance. Infect Control Hosp Epidemiol 2006;27:1347–1351.Google Scholar
13. Rioux, C, Grandbastien, B, Astagneau, P. Impact of a six-year control programme on surgical site infections in France: results of the INCISO surveillance. J Hosp Infect 2007;66:217–223.Google Scholar
14. Couris, CM, Rabilloud, M, Ecochard, R, et al. Nine-year downward trends in surgical site infection rate in southeast France (1995-2003). J Hosp Infect 2007;67:127–134.Google Scholar
15. Poulsen, KB, Jepsen, OB. Failure to detect a general reduction of surgical wound infections in Danish hospitals. Dan Med Bull 1995;42:485–488.Google Scholar
16. Delgado-Rodriguez, M, Gomez-Ortega, A, Sillero-Arenas, M, Martinez-Gallego, G, Medina-Cuadros, M, Llorca, J. Efficacy of surveillance in nosocomial infection control in a surgical service. Am J Infect Control 2001;29:289–294.Google Scholar
17. McConkey, SJ, L'Ecuyer, PB, Murphy, DM, Leet, TL, Sundt, TM, Fraser, VJ. Results of a comprehensive infection control program for reducing surgical-site infections in coronary artery bypass surgery: further data from the authors. Infect Control Hosp Epidemiol 1999;20:791–792.CrossRefGoogle ScholarPubMed
18. Olson, M, O'Connor, M, Schwartz, ML. Surgical wound infections: a 5-year prospective study of 20,193 wounds at the Minneapolis VA Medical Center. Ann Surg 1984;199:253–259.Google Scholar
19. Manniën, J, van Kasteren, ME, Nagelkerke, NJ, et al. Effect of optimized antibiotic prophylaxis on the incidence of surgical site infection. Infect Control Hosp Epidemiol 2006;27:1340–1346.Google Scholar