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Prospective Surveillance for Surgical Site Infection in St. Petersburg, Russian Federation

Published online by Cambridge University Press:  02 January 2015

Samuel M. Brown ,
Sergey R. Eremin ,
Sergey A. Shlyapnikov ,
Elena A. Petrova ,
Ludmila V. Shirokova ,
Donald Goldmann  and
Edward J. O'Rourke
Samuel M. Brown*
Affiliation:
Davis Center for Russian Studies, Harvard University, Cambridge, Boston, Massachusetts Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University Of Utah Health Sciences Center, Salt Lake City
Sergey R. Eremin
Affiliation:
Department of Epidemiology, Mechnikov Medical Academy, St. Petersburg, Russian Federation
Sergey A. Shlyapnikov
Affiliation:
Department of Surgery, Clinical Railroad Hospital, St. Petersburg, Russian Federation
Elena A. Petrova
Affiliation:
Department of Epidemiology, 26th Municipal Hospital, St. Petersburg, Russian Federation
Ludmila V. Shirokova
Affiliation:
Department of Epidemiology, 4th Municipal Hospital, St. Petersburg, Russian Federation
Donald Goldmann
Affiliation:
Department of Infectious Diseases, Children's Hospital, Boston, Massachusetts
Edward J. O'Rourke
Affiliation:
Department of Infectious Diseases, Harvard Medical School, Boston, Massachusetts
*
Division of Respiratory, Critical Care, and Occupational Pulmonary Medicine, University of Utah Health Sciences Center, Wintrobe 701, 26 North 1900 East, Salt Lake City, Utah 84132 ([email protected])
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Abstract

Objective.

To assess the risk-adjusted incidence and predictors of surgical site infections (SSIs).

Design.

Prospective, multicenter, observational cohort study.

Setting.

Seven surgical departments at 3 urban academic hospitals in St. Petersburg, Russian Federation.

Patients.

All patients had surgery performed between January 15 and May 12, 2000. A total of 1,453 surgical procedures were followed up. Medical records were unavailable for less than 3% of all patients; patients were not excluded for any other reason. The mean patient age was 49.3 years, 61% were female, and 34% had an American Society of Anesthesiologists physical status classification (hereafter, “ASA classification”) of at least 3. Surgery for 45% of the patients was emergent.

Results.

In all, 138 patients (9.5%) developed SSI, for a rate that was approximately 3.5 times the risk-stratified rates in the United States. Male sex (odds ratio [OR], 1.54), ASA classifications of 3 (OR, 3.7) or 4 (OR, 5.0), longer duration of surgery (OR, 2.2), and wound classes of 3 (OR, 5.5) or 4 (OR, 14.3) were associated with increased SSI risk in multivariate analysis. Endoscopic surgery was associated with a lower risk of SSI (OR, 0.23). Antibiotic prophylaxis was used in 0%-33% of operations, and 69% of uninfected patients received antibiotics after the operation.

Conclusions.

The SSI rates are significantly higher than previously reported. Although this finding may be attributable to inadequate antibiotic prophylaxis, local infection control and surgical practices may also be contributors. Use of antibiotic prophylaxis should be encouraged and the effect of local practices further investigated. Active SSI surveillance should be expanded to other parts of the Russian Federation.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 3 , March 2007 , pp. 319 - 325
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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