Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-24T04:39:32.915Z Has data issue: false hasContentIssue false
  • English
  • Français

Prevalence of Nosocomial Infections After Surgery in Greek Hospitals: Results of Two Nationwide Surveys

Published online by Cambridge University Press:  02 January 2015

Achilleas Gikas ,
Maria Roumbelaki ,
John Pediaditis ,
Pavlos Nikolaidis ,
Stamatina Levidiotou ,
Sofia Kartali ,
John Kioumis ,
Efstratios Maltezos ,
Symeon Metalidis  and
Eleftherios Anevlavis
...Show all authors
Achilleas Gikas*
Affiliation:
University Hospital of Heraklion, Crete, Greece
Maria Roumbelaki
Affiliation:
University Hospital of Heraklion, Crete, Greece
John Pediaditis
Affiliation:
Venizelion General Hospital of Heraklion, Crete, Greece
Pavlos Nikolaidis
Affiliation:
‘AXEPA’ General Hospital of Thessalonica, Thessalonica, Greece
Stamatina Levidiotou
Affiliation:
University Hospital of Ioannina, Ioannina, Greece
Sofia Kartali
Affiliation:
University Hospital of Alexandroupolis, Alexandroupolis, Greece
John Kioumis
Affiliation:
Papanikolaou' University Hospital of Thessalonica, Thessalonica, Greece
Efstratios Maltezos
Affiliation:
University Hospital of Alexandroupolis, Alexandroupolis, Greece
Symeon Metalidis
Affiliation:
‘AXEPA’ General Hospital of Thessalonica, Thessalonica, Greece
Eleftherios Anevlavis
Affiliation:
‘Agia Olga’ General Hospital of Athens, Athens, Greece
George Haliotis
Affiliation:
General Hospital of Halkis, Halkis, Greece
Hariton Kolibiris
Affiliation:
‘Agia Olga’ General Hospital of Athens, Athens, Greece
Yiannis Tselentis
Affiliation:
University Hospital of Heraklion, Crete, Greece
*
University Hospital of Heraklion1352/71110, Crete, Greece
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To determine the frequency and type of nosocomial infections (NIs) (especially surgical-site infections [SSIs]), risk factors, and the type and duration of antibiotic use among surgical patients in Greek hospitals.

Design:

Two point-prevalence studies.

Setting:

Fourteen Greek hospitals.

Patients:

Those in the hospitals during two prevalence surveys undergoing surgery during their stay.

Results:

In the 1999 survey, 129 of 1,037 surgical patients had developed 148 NIs (14.3%). A total of 1,093 operations were registered, and 49 SSIs (4.5%) were found. In the 2000 survey, 82 of 868 surgical patients had developed 88 NIs (10.1%). A total of 902 operations were registered, and 38 SSIs were detected (4.2%). The median length of stay (LOS) for surgical patients without SSI was 10.0 days (range, 1-19 days); for patients who developed SSI it was 30 days (range, 1-52 days; P < .001). The median LOS prior to surgery for patients without SSI was 1 day (range, 0-4 days); for patients who developed SSI it was 3 days (range, 0-7.5 days; P < .001). Among 30 possible risk factors studied, wound class, LOS prior to surgery, and central venous catheterization were independent predictors of SSI. Median durations of prophylactic antibiotic therapy were 4 days (range, 1-14 days) and 6 days (range, 1-16 days) in the 1999 and 2000 surveys, respectively.

Conclusion:

Surgical patients in Greek hospitals suffered higher rates of SSI than did surgical patients in other developed countries while prophylactic antibiotics were used excessively.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 25 , Issue 4 , April 2004 , pp. 319 - 324
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2004

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 on preventing nosocomial infection in US hospitals. Am J Epidemiol 1985;121:182–205.Google Scholar
2.French, GL, Wong, SL, Cheng, AFB, et al.Repeated prevalence surveys for monitoring effectiveness of hospital infection control. Lancet 1989;2:1021–1023.Google Scholar
3.Gikas, A, Pediaditis, J, Roumbelaki, M, et al.Repeated multi-centre prevalence surveys of hospital-acquired infection in Greek hospitals. J Hosp Infect 1999;41:11–18.CrossRefGoogle ScholarPubMed
4.Gikas, A, Pediaditis, J, Papadakis, JA, et al.Prevalence study of hospital-acquired infections in 14 Greek hospitals: planning from the local to the national surveillance level. J Hosp Infect 2002;50:269–275.Google Scholar
5.Glenister, H, Taylor, L, Bartlett, C, et al.An evaluation of surveillance methods for detecting infections in hospital inpatients. J Hosp Infect 1993;23:229–242.Google Scholar
6.Garner, JS, Jarvis, WR, Emori, TG, et al.CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.Google Scholar
7.Horan, TC, Gaynes, RP, Martone, WJ, et al.CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606–608.Google Scholar
8.Emori, TG, Culver, DH, Horan, TC, et al.National Nosocomial Infections Surveillance System (NNIS): description of surveillance methods. Am J Infect Control 1991;19:19–35.CrossRefGoogle ScholarPubMed
9.Merle, V, Germain, JM, Chamouni, P, et al.Assessment of prolonged hospital stay attributable to surgical site infections using appropriateness evaluation protocol. Am J Infect Control 2000;28:109–115.Google Scholar
10.Vegas, AA, Jodra, VM, Garcia, ML. Nosocomial infection in surgery wards: a controlled study of increased duration of hospital stays and direct cost of hospitalization. Eur J Epidemiol 1993;9:504–510.Google Scholar
11.Ronveaux, O, Mertens, R, Dupont, Y. Surgical wound surveillance: results from the Belgium hospital network. Acta Chir Belg 1996;96:3–10.Google Scholar
12.Kjaeldgaard, P, Cordtz, T, Sejberg, D, et al.The DANOP-DATA system: a low-cost personal computer based program for monitoring of wound infections in surgical wards. J Hosp Infect 1989;13:273–279.Google Scholar
13.National Nosocomial Infections Surveillance (NNIS) System. National Nosocomial Infections Surveillance (NNIS) System report: data summary from January 1992-June 2001, issued August 2001. Am J Infect Control 2001;29:404–421.Google Scholar
14.Sohn, AH, Parvez, FM, Vu, T, 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.Google Scholar
15.Gaynes, RP. Surveillance of surgical-site infections: the world coming together? Infect Control Hosp Epidemiol 2000;21:309–310.CrossRefGoogle ScholarPubMed
16.Mertens, R, Van de Berg, JM, Veerman-Brenzikofer, ML, et al.International comparison of results of infection surveillance: The Netherlands versus Belgium. Infect Control Hosp Epidemiol 1994;15:574–580.Google Scholar
17.Emori, TG, Gaynes, RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6:428–442.Google Scholar
18.Malone, DL, Genuit, T, Tracy, JK, et al.Surgical site infections: reanalysis of risk factors. J Surg Res 2002;103:89–95.CrossRefGoogle ScholarPubMed
19.Jepsen, OB, Jensen, LP, Zimakoff, J, et al.Prevalence of infections and use of antibiotics among hospitalized patients in Mauritius: a nation-wide survey for the planning of a national infection control programme. J Hosp Infect 1993;25:271–278.Google Scholar
20.Martone, WJ, Jarvis, WR, Culver, DH, et al.Incidence and nature of endemic and epidemic nosocomial infections. In: Bennett, JV, Brachman, PS, eds. Hospital Infections. Boston: Little, Brown; 1992:577–596.Google Scholar
21.Rojo, D, Pinedo, A, Clavijo, E, et al.Analysis of risk factors associated with nosocomial bacteraemias. J Hosp Infect 1999;42:135–141.Google Scholar
22.Culver, DH, Horan, TC, Gaynes, RP, et al.Surgical wound infection rates by wound class, operative procedure, and patient risk index. Am J Med 1991;91(3B):S152–S157.Google Scholar
23.Coello, R, Glenister, H, Fereres, J, et al.The cost of infection in surgical patients: a case control study. J Hosp Infect 1993;25:239–250.Google Scholar
24.Kirkland, KB, Briggs, JP, Trivette, SL, et al.The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999;20:725–730.Google Scholar
25.Geubbels, EL, Mintjes-de Groot, AJ, van den Berg, JM, et al.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
26.Dellinger, EP, Gross, PA, Barrett, TL, et al.Quality standard for antimicrobial prophylaxis in surgical procedures. Clin Infect Dis 1994;18:422–427.Google Scholar
27.Nichols, RL. Preventing surgical site infections: a surgeon's perspective. Emerg Infect Dis 2001;7:220–224.CrossRefGoogle ScholarPubMed
28.Vatopoulos, AC, Kalapothaki, V, Legakis, NJ. Bacterial resistance to ciprofloxacin in Greece: results from the National Electronic Surveillance System. Greek Network for the Surveillance of Antimicrobial Resistance. Emerg Infect Dis 1999;5:471–476.Google Scholar