To report a program of continuous surveillance of surgical-site infections (SSIs) using basic surveillance methods.

Analysis of routine prospective surveillance data.

Two hospitals in Ireland (300 and 350 beds) that merged and moved to a new 650-bed hospital in 1987.

59,335 surgical sites of postoperative patients.

Surgical sites were surveyed by one infection control nurse and SSI rates were produced for selected operations and surgical services. The program was conducted in general accordance with the 1999 HICPAC guidelines, but differed in surveillance strategy. Operations were limited to two to three risk classifications, assigned by the infection control nurse.

The overall SSI rate was 4.5%, with 2.4% in clean surgery. Apart from increases in the 3rd, 4th, 13th, and 14th years, rates remained relatively stable during the 16 years. Few significant decreases in SSI rates in surgical services or specific operations were shown, apart from the following: vascular surgery, 8.1% to 5% between the first 8 years and the last 8 years; general surgery services, 9% to 5%, and gynecology, 15.8% to 1.7%, both in the first year compared with in subsequent years; and gastric operations, 21% to 4.3% between the first year and the second year. Organ/space infection was identified in 0.5% of 17,804 operations, including 0.4% meningitis after neurosurgical procedures, 3% graft infections after vascular bypass operations, and 0.2% intra-abdominal infections after abdominal surgery.

With the use of basic principles of surveillance and modest resources, procedure-specific SSI rates were produced, with little significant change during the 16 years. Despite limitations in case-finding, risk stratification, feedback, and surveillance methods, the overall SSI rates were comparable with other published data.

Investigation of an outbreak of influenza A in a neonatal intensive care unit (NICU) with examination of risk factors for infection and outcomes.

Retrospective cohort study of infants admitted to the unit during the outbreak period. Prospective survey of NICU staff and mothers of infants in the cohort study.

Level III nursery in a university-affiliated tertiary referral center.

Nineteen infants in the NICU were infected with influenza A. There were six symptomatic cases and one death who had evidence of virus-associated hemophagocytic syndrome at autopsy. Amantadine prophylaxis was offered to the NICU staff, and amantadine therapy was given to five of the six symptomatic infants. Mechanical ventilation, gestational age, birth weight, Clinical Risk Index for Babies score, and twin pregnancy were associated with acquisition of influenza A on univariate analysis. Mechanical ventilation (odds ratio [OR], 6.2; P=.02) and twin pregnancy (OR, 7.0; P=.04) remained as significant risk factors for infection on multiple logistic regression analysis. Only 15% of respondents to the NICU staff survey were vaccinated against influenza. There was no association between a history of an influenza-like illness during pregnancy and acquisition of influenza A by infants of mothers who responded to the maternal survey (OR, 0.91; P=1.0).

Influenza A is an important pathogen in the neonatal population and is readily transmissible in the NICU setting.