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Factors Associated With Surgical Site Infection Following Gastric Surgery in Japan

Published online by Cambridge University Press:  19 July 2016

Keita Morikane*
Affiliation:
Division of Infection Control and Clinical Laboratory, Yamagata University Hospital, Yamagata, Japan
Hitoshi Honda
Affiliation:
Division of Infectious Diseases, Tokyo Metropolitan Tama Medical Center, Fuchu, Tokyo, Japan
Satowa Suzuki
Affiliation:
Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan
*
Address correspondence to Keita Morikane, MD, PhD, Division of Infection Control and Clinical Laboratory, Yamagata University Hospital, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan ([email protected]).

Abstract

BACKGROUND

Surgical site infection (SSI) following gastric surgery has not been well documented.

OBJECTIVE

To describe and assess factors associated with SSI following gastric surgery in Japan using a Japanese national database for healthcare-associated infections.

DESIGN

A retrospective nationwide surveillance-based study.

SETTING

Japanese healthcare facilities.

METHODS

Data on gastric surgeries performed between 2012 and 2014 were extracted from the Japan Nosocomial Infections Surveillance. Gastric surgery was divided into 3 types of procedures: total gastrectomy (GAST-T), distal gastrectomy (GAST-D), and other types of gastric surgery (GAST-O). The incidence of and factors associated with SSI following gastric surgery were assessed by the 3 types of procedures.

RESULTS

The cumulative incidence of SSI following gastric surgery was 8.8% (3,156/36,052). The incidence of SSI following GAST-T (12.4%) was significantly higher than that following GAST-D (7.01%) or GAST-O (7.84%). Besides the 4 conventional risk factors for predicting SSI, additional risk factors were identified. Male sex was significantly associated with SSI following all types of gastric surgery, but the effect of the association was substantially different (adjusted odds ratio, 1.52, 1.47, and 1.28 for GAST-T, GAST-D, and GAST-O, respectively). The effect of an emergency operation was similar. Age was also identified as a risk factor, but the most suitable modification of age as a variable differed.

CONCLUSIONS

The incidence and factors associated with SSI following 3 types of gastric surgery differed. To accurately compare hospital performance in SSI prevention following gastric surgery, dividing surgical procedures in the surveillance system into 3 types should be considered.

Infect Control Hosp Epidemiol 2016;1–6

Type
Original Articles
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

Presented in part: IDWeek 2014; Philadelphia, Pennsylvania; October 10, 2014 (abstract 1012).

References

REFERENCES

1. Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR. Guideline for prevention of surgical site infection, 1999. Am J Infect Control 1999;27:97134.Google Scholar
2. Magill, SS, Edwards, JR, Bamberg, W, et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014;370:11981208.Google Scholar
3. Cruse, P. Wound infection surveillance. Rev Infect Dis 1981;3:734737.Google Scholar
4. Engemann, JJ, Carmeli, Y, Cosgrove, SE, et al. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis 2003;36:592598.CrossRefGoogle ScholarPubMed
5. Kirkland, KB, Briggs, JP, Trivette, 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;20:725730.Google Scholar
6. 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;91:152S157S.Google Scholar
7. Gaynes, RP, Culver, DH, Horan, TC, et al. Surgical site infection rates in the United States, 1992-1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis 2001;33:S69S77.CrossRefGoogle ScholarPubMed
8. NHSN newsletter. Centers for Disease Control and Prevention website. http://www.cdc.gov/nhsn/PDFs/Newsletters/NHSN_NL_OCT_2010SE_final.pdf. Published October 2010. Accessed May 17, 2016.Google Scholar
9. Mu, Y, Edwards, JR, Horan, TC, Berrios-Torres, SI, Fridkin, SK. Improving risk-adjusted measures of surgical site infection for the National Healthcare Safety Network. Infect Control Hosp Epidemiol 2011;32:970986.CrossRefGoogle ScholarPubMed
10. Lo, CH, Chen, JH, Wu, CW, Lo, SS, Hsieh, MC, Lui, WY. Risk factors and management of intra-abdominal infection after extended radical gastrectomy. Am J Surg 2008;196:741745.Google Scholar
11. Migita, K, Takayama, T, Matsumoto, S, et al. Risk factors for surgical site infections after elective gastrectomy. J Gastrointest Surg 2012;16:11071115.CrossRefGoogle ScholarPubMed
12. Jeong, SJ, Kim, CO, Han, SH, et al. Risk factors for surgical site infection after gastric surgery: a multicentre case-control study. Scand J Infect Dis 2012;44:419426.CrossRefGoogle ScholarPubMed
13. Kim, ES, Kim, HB, Song, KH, et al. Prospective nationwide surveillance of surgical site infections after gastric surgery and risk factor analysis in the Korean Nosocomial Infections Surveillance System (KONIS). Infect Control Hosp Epidemiol 2012;33:572580.CrossRefGoogle ScholarPubMed
14. Jeong, SJ, Ann, HW, Kim, JK, et al. Incidence and risk factors for surgical site infection after gastric surgery: a multicenter prospective cohort study. Infect Chemother 2013;45:422430.Google Scholar
15. Morikane, K, Honda, H, Yamagishi, T, Suzuki, S, Aminaka, M. Factors associated with surgical site infection in colorectal surgery: the Japan Nosocomial Infections Surveillance. Infect Control Hosp Epidemiol 2014;35:660666.Google Scholar
16. Imai, E, Ueda, M, Kanao, K, et al. Surgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery. Am J Infect Control 2008;36:727731.CrossRefGoogle ScholarPubMed
17. Morikane, K, Nishioka, M, Tanimura, H, Noguchi, H, Konishi, T, Kobayashi, H. Using surveillance data to direct infection control efforts to reduce surgical-site infections following clean abdominal operations in Japan. Infect Control Hosp Epidemiol 2002;23:404406.Google Scholar
18. Hirao, M, Tsujinaka, T, Imamura, H, et al. Overweight is a risk factor for surgical site infection following distal gastrectomy for gastric cancer. Gastric Cancer 2013;16:239244.CrossRefGoogle ScholarPubMed
19. Ozalp, N, Zülfikaroğlu, B, Göçmen, E, et al. Risk factors for surgical site infection after gastrectomy with D2 lymphadenectomy. Surg Today 2009;39:10131015.Google Scholar