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International Comparison of Results of Infection Surveillance: The Netherlands Versus Belgium

Published online by Cambridge University Press:  02 January 2015

R. Mertens ,
J.M. Van den Berg ,
M.L.V. Veerman-Brenzikofer ,
X. Kurz ,
B. Jans  and
N. Klazinga
R. Mertens*
Affiliation:
Institute of Hygiene and Epidemiology, Brussels, Belgium
J.M. Van den Berg
Affiliation:
Centraal Begeleidingsorgaan voor Intercollegiale Toetsing (CBO), Utrecht, The Netherlands
M.L.V. Veerman-Brenzikofer
Affiliation:
Afdeling Ziekenhuishygiëne, Medisch Centrum, Alkmaar, The Netherlands.
X. Kurz
Affiliation:
Institute of Hygiene and Epidemiology, Brussels, Belgium
B. Jans
Affiliation:
Institute of Hygiene and Epidemiology, Brussels, Belgium
N. Klazinga
Affiliation:
Centraal Begeleidingsorgaan voor Intercollegiale Toetsing (CBO), Utrecht, The Netherlands
*
Institute of Hygiene and Epidemiology, Epidemiology Section, J. Wytsmanstraat 14, B-1050, Brussels, Belgium.
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Abstract

Objective:

To explore the potential benefit of comparing results from two national surveillance networks.

Design:

Two prospective multicenter cohort studies of surgical wound infections (SWI).

Setting:

Thirty-five and 62 acute-care hospitals in The Netherlands (NL) and Belgium (B), respectively, from October 1, 1991, to June 30, 1992.

>Results:

The participation was equivalent in the two countries: 27% (NL) and 28% (B) of all acute-care hospitals.

Marked differences emerged between the Dutch and Belgian crude infection rates and the specific rates by wound class and other risk factors.

Because the case-mix in the countries is quite different, comparisons can be made only by specific surgical category. The results for inguinal hernia repair and for appendectomy are compared as an example.

In hemiorrhaphies, the difference in infection rate (0.4% [NL] versus 1.2% [B]) is not explained by differences in the distribution of risk factors. The shorter hospital stay in The Netherlands (4 days [NL] versus 6 days [B]), the more effective postdischarge surveillance in Belgium, and the fact that more than two thirds of the detected infections occurred after the first postoperative week probably can account for most of the difference. There was a striking difference in prophylaxis use (3.7% [ NL] versus 41.9% [B]).

In appendectomies, the Dutch patient population shows on average a higher risk profile, and surgery is urgent much more often in The Netherlands (78.3%) than in Belgium (49.2%). The infection rate is higher in The Netherlands, especially among the patients without prophylaxis, which again is employed less frequently there.

Conclusion:

We conclude that international comparisons yield interesting insights regarding quality of care, reaching beyond the field of nosocomial infection prevention. This is an argument in favor of more harmonization between surveillance networks.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 15 , Issue 9 , September 1994 , pp. 574 - 580
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1994

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References

1. Mertens, R. Jans, B, Kurz, X. A computerized nationwide network for nosocomial infection surveillance in Belgium. Infect Control Hosp Epidemiol 1994;15:171–179.CrossRefGoogle Scholar
2. 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.Google Scholar
3. Garner, JS, Jarvis, WR, Emori, TG, Horan, TC, Hughes, JM. CDC definitions for nosocomial infections, 1988. Am J Infect Control 1988;16:128–140.Google Scholar
4. Horan, TC, Gaynes, RR Martone, WJ, Jarvis, WR, Emori, G. 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
5. Mertens, R, The WHOCARE Software Development Group. The WHOCARE software. Combining local surveillance and multicenter monitoring of quality of care. Presented at the 2nd International Conference of the Hospital Infection Society; September 2-6, 1990; London, England.Google Scholar
6. Editorial. The ASA classification of physical status: a recapitulation. J Anes 1978;49:233–236.CrossRefGoogle Scholar
7. Owens, WD, Felts, JA, Spitznagel, EL. ASA physical status classifications: A study of consistency of ratings. J Anes 1978;49:239–243.CrossRefGoogle ScholarPubMed
8. Altemeier, WA, Burke, JF Pruitt, BA, Sandusky, WR. eds. Manual on Control of Infection in Surgical fatients. 2nd ed. Philadelphia, PA: JB Lippincott; 1984;29.Google Scholar
9. Cox, DR. Regression models and life-tables. J R Stat Soc, Series B 1972;34:187–220.Google Scholar
10. Platt, R, Zaleznik, DE Hopkins, CC, et al. Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery. N Engl J Med 1990;322:153–160, 1884-1885.CrossRefGoogle ScholarPubMed
11. Krukowski, ZH. Preventing wound infection after appendicectomy: a review. Br J Surg 1988;75: 1023–1033.Google Scholar