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Reduction of Surgical Site Infection Rates Associated With Active Surveillance

Published online by Cambridge University Press:  21 June 2016

C. Brandt ,
D. Sohr ,
M. Behnke ,
F. Daschner ,
H. Rüden  and
P. Gastmeier
C. Brandt*
Affiliation:
Institut für Hygiene und Umweltmedizin, Charité-Universitätsmedizin Berlin, Freie UniversitätandHumboldt Universität, Berlin National Reference Center for the Surveillance of Nosocomial Infections, Berlin
D. Sohr
Affiliation:
Institut für Hygiene und Umweltmedizin, Charité-Universitätsmedizin Berlin, Freie UniversitätandHumboldt Universität, Berlin National Reference Center for the Surveillance of Nosocomial Infections, Berlin
M. Behnke
Affiliation:
Institut für Hygiene und Umweltmedizin, Charité-Universitätsmedizin Berlin, Freie UniversitätandHumboldt Universität, Berlin National Reference Center for the Surveillance of Nosocomial Infections, Berlin
F. Daschner
Affiliation:
National Reference Center for the Surveillance of Nosocomial Infections, Berlin Institut für Umweltmedizin und Krankenhaushygiene, Albert-Ludwigs-Universität, Freiburg/Breisgau, Germany
H. Rüden
Affiliation:
Institut für Hygiene und Umweltmedizin, Charité-Universitätsmedizin Berlin, Freie UniversitätandHumboldt Universität, Berlin National Reference Center for the Surveillance of Nosocomial Infections, Berlin
P. Gastmeier
Affiliation:
National Reference Center for the Surveillance of Nosocomial Infections, Berlin Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule, Hannover, Germany
*
Institut für Hygiene und Umweltmedizin, Charité-Universitätsmedizin Berlin, Hindenburgdamm 27, 12200 Berlin, Germany (christian.brandt@kgu.de)
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Abstract

Objective.

To evaluate whether surgical site infection (SSI) rates decrease in surgical departments as a result of performing active SSI surveillance.

Design.

Retrospective multiple logistic regression analyses.

Setting.

A group of 130 surgical departments of German hospitals participating in the Krankenhaus Infektions Surveillance System (KISS).

Methods.

Data for 19 categories of operative procedures performed between January 1997 and June 2004 were included (119,114 operations). Active SSI surveillance was performed according to National Nosocomial Infections Surveillance system (NNIS) methods and definitions. Departments' SSI rates were calculated individually for each year of surveillance and for each operative procedure category, taking into account when the individual departments had begun their surveillance activities. Multiple logistic regression analyses on a single operation basis were carried out with stepwise variable selection to predict outcomes for patients with SSI. The variables included were as follows: the department's year of participation, NNIS risk index variables, patients' age and sex, and the hospitals' structural characteristics, such as yearly operation frequency, number of beds, and academic status.

Results.

For 14 of 19 operative procedure categories analyzed, there was a tendency toward lower SSI rates that was associated with increasing duration of SSI surveillance. In multiple logistic regression analyses of pooled data for all operative procedures, the departments' participation in the surveillance system was a significant independent protective factor. Compared with the surveillance year 1, the SSI risk decreased in year 2 (odds ratio, 0.84; 95% confidence interval, 0.77-0.93) and in year 3 (odds ratio, 0.75; 95% confidence interval, 0.68-0.82), and there was no change in year 4.

Conclusion.

The SSI incidence was reduced by one quarter as a result of the surveillance-induced infection control efforts, which indicates the usefulness of a voluntary surveillance system.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 12 , December 2006 , pp. 1347 - 1351
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1. Coello, R, Charlett, A, Wilson, J, Ward, V, Pearson, A, Borriello, P. Adverse impact of surgical site infections in English hospitals. J Hosp Infect 2005; 60:93–103.Google Scholar
2. Kirkland, KB, Briggs, JP, Trivetre, SL, Wilkinson, WE, Sexton, DJ. 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.CrossRefGoogle ScholarPubMed
3. 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
4. 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.Google Scholar
5. Harbarth, S, Sax, H, Gastmeier, P. The preventable proportion of nosocomial infections: an overview of published reports. J Hosp Infect 2003; 54:258–266.CrossRefGoogle ScholarPubMed
6. Geubbels, EL, Bakker, HG, Houtman, P, et al. Promoting quality through surveillance of surgical site infections: five prevention success stories. Am J Infect Control 2004; 32:424–430.Google Scholar
7. Schneeberger, PM, Smits, MH, Zick, RE, Wille, JC. Surveillance as a starting point to reduce surgical-site infection rates in elective orthopaedic surgery. J Hosp Infect 2002; 51:179–184.CrossRefGoogle ScholarPubMed
8. Condon, RE, Schulte, WJ, Malangoni, MA, Anderson-Teschendorf, MJ. Effectiveness of a surgical wound surveillance program. Arch Surg 1983; 118:303–307.Google Scholar
9. Horan, TC, Emori, TG. Definitions of key terms used in the NNIS System. Am J Infect Control 1997; 25:112–116.CrossRefGoogle ScholarPubMed
10. Brandt, C, Hansen, S, Sohr, D, Daschner, F, Rüden, H, Gastmeier, P. Finding a method for optimizing risk adjustment when comparing surgical-site infection rates. Infect Control Hosp Epidemiol 2004; 25:313–318.Google Scholar
11. Nosokomiale Infektionen: KISS-Daten zu postoperativen Wundinfektionen. Epidemiol Bull 2003; 36:290–292.Google Scholar
12. Nationales Referenzzentrumfur Surveillance von nosokomialen Infektionen Web site. Available at: http://www.nrz-hygiene.de/english.htm. Accessed November 10, 2006.Google Scholar
13. Geubbels, EL. Prevention of Surgical Site Infections Through Surveillance. Utrecht, the Netherlands: Universiteit Utrecht; 2002:151.Google Scholar
14. Byrne, DJ, Lynch, W, Napier, A, Davey, P, Malek, M, Cuschieri, A. Wound infection rates: the importance of definition and post-discharge wound surveillance. J Hosp Infect 1994; 26:37–43.CrossRefGoogle ScholarPubMed
15. Sands, K, Vineyard, G, Platt, R. Surgical site infections occurring after hospital discharge. J Infect Dis 1996; 173:963–970.CrossRefGoogle ScholarPubMed
16. Mitchell, DH, Swift, G, Gilbert, GL. Surgical wound infection surveillance: the importance of infections that develop after hospital discharge. Aust N Z J Surg 1999; 69:117–120.Google Scholar