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Surgical Site Infections, International Nosocomial Infection Control Consortium (INICC) Report, Data Summary of 30 Countries, 2005–2010

Published online by Cambridge University Press:  02 January 2015

Victor D. Rosenthal*
Affiliation:
International Nosocomial Infection Control Consortium, Buenos Aires, Argentina
Rosana Richtmann
Affiliation:
Hospital Maternidade Santa Joana, São Paulo, Brazil
Sanjeev Singh
Affiliation:
Amrita Institute of Medical Sciences, and Research Center, Kochi, India
Anucha Apisarnthanarak
Affiliation:
Thammasart University Hospital, Pratumthani, Thailand
Andrzej Kübler
Affiliation:
University Hospital of Wroclaw, Wroclaw, Poland
Nguyen Viet-Hung
Affiliation:
Bach Mai Hospital, Hanoi, Vietnam
Fernando M. Ramírez-Wong
Affiliation:
Hospital de Emergencias José Casimiro Ulloa, Lima, Peru
Jorge H. Portillo-Gallo
Affiliation:
CIMA, Chihuahua, Mexico
Jessica Toscani
Affiliation:
Sanatorio Amedrin, Fray Bentos, Uruguay
Achilleas Gikas
Affiliation:
University Hospital of Heraklion, Heraklion, Greece
Lourdes Dueñas
Affiliation:
Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador
Amani El-Kholy
Affiliation:
Dar Al Fouad Hospital, Cairo, Egypt
Sameeh Ghazal
Affiliation:
King Fahad Medical City, Riyadh, Saudi Arabia
Dale Fisher
Affiliation:
National University Hospital, Singapore, Republic of Singapore
Zan Mitrev
Affiliation:
Filip II Special Hospital for Surgery, Skopje, Macedonia
May Osman Gamar-Elanbya
Affiliation:
Bahry Teaching Hospital, Khartoum, Sudan Khartoum Dental Teaching Hospital, Khartoum, Sudan
Souha S. Kanj
Affiliation:
American University of Beirut Medical Center, Beirut, Lebanon
Yolanda Arreza-Galapia
Affiliation:
National Kidney and, Transplant Institute, Quezon City, Philippines
Hakan Leblebicioglu
Affiliation:
Ondokuz Mayis University Medical School, Samsun, Turkey
Soňa Hlinková
Affiliation:
Catholic University, Faculty of Medicine, Ružomberok, Slovakia Military Hospital SNP Ružomberok, Ružomberok, Slovakia
Badaruddin A. Memon
Affiliation:
Public Sector Hospital Khairpur, Sindh, Pakistan
Humberto Guanche-Garcell
Affiliation:
Hospital Docente Clínico Quirúrgico “Joaquín Albarrán Domínguez, ” Havana, Cuba
Vaidotas Gurskis
Affiliation:
Lithuanian University of Health Sciences, Kaunas, Lithuania
Carlos Álvarez-Moreno
Affiliation:
Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia
Amina Barkat
Affiliation:
Children's Hospital of Rabat, Rabat, Morocco
Nepomuceno Mejía
Affiliation:
Hospital General de la Plaza de la Salud, Santo Domingo, Dominican Republic
Magda Rojas-Bonilla
Affiliation:
Hospital de Especialidades Pediátricas “Omar Torrijos Herrera, ”Panama City, Panama
Goran Ristic
Affiliation:
Mother and Child Health Institute of Serbia, Belgrade, Serbia
Lul Raka
Affiliation:
National Institute for Public Health of Kosovo and Medical School, Prishtina University, Prishtina, Kosovo
Cheong Yuet-Meng
Affiliation:
Sunway Medical Centre Berhad and, Monash University Sunway Campus, Petaling Jaya, Malaysia
*
International Nosocomial Infection Control Consortium, Corrientes Avenue #4580, Floor 12, Apartment D, Buenos Aires 1195, Argentina (victor_rosenthal@inicc.org).

Abstract

Objective.

To report the results of a surveillance study on surgical site infections (SSIs) conducted by the International Nosocomial Infection Control Consortium (INICC).

Design.

Cohort prospective multinational multicenter surveillance study.

Setting.

Eighty-two hospitals of 66 cities in 30 countries (Argentina, Brazil, Colombia, Cuba, Dominican Republic, Egypt, Greece, India, Kosovo, Lebanon, Lithuania, Macedonia, Malaysia, Mexico, Morocco, Pakistan, Panama, Peru, Philippines, Poland, Salvador, Saudi Arabia, Serbia, Singapore, Slovakia, Sudan, Thailand, Turkey, Uruguay, and Vietnam) from 4 continents (America, Asia, Africa, and Europe).

Patients.

Patients undergoing surgical procedures (SPs) from January 2005 to December 2010.

Methods.

Data were gathered and recorded from patients hospitalized in INICC member hospitals by using the methods and definitions of the Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) for SSI. SPs were classified into 31 types according to International Classification of Diseases, Ninth Revision, criteria.

Results.

We gathered data from 7,523 SSIs associated with 260,973 SPs. SSI rates were significantly higher for most SPs in INICC hospitals compared with CDC-NHSN data, including the rates of SSI after hip prosthesis (2.6% vs 1.3%; relative risk [RR], 2.06 [95% confidence interval (CI), 1.8–2.4]; P<.001), coronary bypass with chest and donor incision (4.5% vs 2.9%; RR, 1.52 [95% CI, 1.4–1.6]; P<.001); abdominal hysterectomy (2.7% vs 1.6%; RR, 1.66 [95% CI, 1.4–2.0]; P<.001); exploratory abdominal surgery (4.1 % vs 2.0%; RR, 2.05 [95% CI, 1.6–2.6]; P<.001); ventricular shunt, 12.9% vs 5.6% (RR, 2.3 [95% CI, 1.9–2.6]; P<.001), and others.

Conclusions.

SSI rates were higher for most SPs in INICC hospitals compared with CDC-NHSN data.

Type
Original Article
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Harrop, JS, Styliaras, JC, Ooi, YC, Radcliff, KE, Vaccaro, AR, Wu, C. Contributing factors to surgical site infections. J Am Acad Orthop Surg 2012;20:94101.CrossRefGoogle ScholarPubMed
2.Umscheid, CA, Mitchell, MD, Doshi, JA, Agarwal, R, Williams, K, Brennan, PJ. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol 2011;32:101114.Google Scholar
3.Rosenthal, VD, Maki, DG, Rodrigues, C, et al.Impact of International Nosocomial Infection Control Consortium (INICC) strategy on central line-associated bloodstream infection rates in the intensive care units of 15 developing countries. Infect Control Hosp Epidemiol 2010;31:12641272.CrossRefGoogle ScholarPubMed
4.Tao, L, Hu, B, Rosenthal, VD, Zhang, Y, Gao, X, He, L. Impact of a multidimensional approach on ventilator-associated pneumonia rates in a hospital of Shanghai: findings of the International Nosocomial Infection Control Consortium. J Crit Care 2012;27:440446.CrossRefGoogle Scholar
5.Rosenthal, VD, Ramachandran, B, Dueñas, L, et al.Findings of the International Nosocomial Infection Control Consortium (INICC), part I: effectiveness of a multidimensional infection control approach on catheter-associated urinary tract infection rates in pediatric intensive care units of 6 developing countries. Infect Control Hosp Epidemiol 2012;33:696703.Google Scholar
6. The World Bank. The World Bank list of economies. World Bank, 2008. http://www.worldbank.org/. Accessed May 12, 2010.Google Scholar
7.Aiken, AM, Karuri, DM, Wanyoro, AK, Macleod, J. Interventional studies for preventing surgical site infections in sub-Saharan Africa: a systematic review. Int J Surg 2012;10:242249.Google Scholar
8.Horan, TC, Andrus, M, Dudeck, MA. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008;36:309332.Google Scholar
9.Emori, TG, Culver, DH, Horan, TC, et al.National nosocomial infections surveillance system (NNIS): description of surveillance methods. Am J Infect Control 1991;19:1935.CrossRefGoogle ScholarPubMed
10.Rosenthal, VD, Maki, DG, Salomao, R, et al.Device-associated nosocomial infections in 55 intensive care units of 8 developing countries. Ann Intern Med 2006;145:582591.Google Scholar
11.Rosenthal, VD, Bijie, H, Maki, DG, et al.International Nosocomial Infection Control Consortium (INICC) report, data summary of 36 countries, for 2004–2009. Am J Infect Control 2012;40:396407.CrossRefGoogle ScholarPubMed
12.Rosenthal, VD, Maki, DG, Graves, N. The International Nosocomial Infection Control Consortium (INICC): goals and objectives, description of surveillance methods, and operational activities. Am J Infect Control 2008;36:e1e12.Google Scholar
13.Williams, CA, Hauser, KW, Correia, JA, Frias, JL. Ascertainment of gastroschisis using the ICD-9-CM surgical procedure code. Birth Defects Res A Clin Mol Teratol 2005;73:646648.Google Scholar
14.Stausberg, J, Lang, H, Obertacke, U, Rauhut, F. Classifications in routine use: lessons from ICD-9 and ICPM in surgical practice. J Am Med Inform Assoc 2001;8:92100.Google Scholar
15.Estrada, JA, Guix, J, Puig, P, Brull, D. Extension of the ICD-9-CM classification of surgical interventions [in Spanish]. Gac Sanit 1987;1:83.Google Scholar
16.Tedeschi, P, Griffith, JR. Classification of hospital patients as “surgical”: implications of the shift to ICD-9-CM. Med Care 1984;22:189192.Google Scholar
17.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;20:250278; quiz 79–80.Google Scholar
18.Edwards, JR, Peterson, KD, Mu, Y, et al.National Healthcare Safety Network (NHSN) report: data summary for 2006 through 2008, issued December 2009. Am J Infect Control 2009;37:783805.CrossRefGoogle ScholarPubMed
19.Allegranzi, B, Bagheri Nejad, S, Combescure, C, et al.Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011;377:228241.CrossRefGoogle ScholarPubMed
20.Lynch, P, Rosenthal, VD, Borg, MA, Eremin, SR. Infection control in developing countries. In: Jarvis, WR, ed. Bennett and Brachman's hospital infections. Philadelphia: Lippincott Williams & Wilkins, 2007:255.Google Scholar
21.Rosenthal, VD. Health-care-associated infections in developing countries. Lancet 2011;377:186188.Google Scholar
22.Rosenthal, VD, Lynch, P, Jarvis, WR, et al.Socioeconomic impact on device-associated infections in limited-resource neonatal intensive care units: findings of the INICC. Infection 2011;39:439550.Google Scholar
23.Rosenthal, VD, Jarvis, WR, Jamulitrat, S, et al.Socioeconomic impact on device-associated infections in pediatric intensive care units of 16 limited-resource countries: International Nosocomial Infection Control Consortium findings. Pediatr Crit Care Med 2012;13:399406.Google Scholar