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Sixteen Years' Surveillance of Surgical Sites in an Irish Acute-Care Hospital

Published online by Cambridge University Press:  02 January 2015

Eilish Creamer ,
Robert J. Cunney ,
Hilary Humphreys  and
Edmond G. Smyth
Eilish Creamer*
Affiliation:
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
Robert J. Cunney
Affiliation:
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
Hilary Humphreys
Affiliation:
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
Edmond G. Smyth
Affiliation:
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland
*
Department of Public Health, Eastern Regional Health Authority, Dr. Steevens' Hospital, Dublin 8, Ireland
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Abstract

Objective:

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

Design:

Analysis of routine prospective surveillance data.

Setting:

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

Patients:

59,335 surgical sites of postoperative patients.

Interventions:

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.

Results:

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.

Conclusions:

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.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 1 , January 2002 , pp. 36 - 40
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Roy, M-C, Perl, TM. Basics of surgical-site infection surveillance. Infect Control Hosp Epidemiol 1997;18:659–668.Google Scholar
2.Cruse, PJE, Foord, R. The epidemiology of wound infection: a 10-year prospective surveillance program of 62,939 wounds. Surg Clin North Am 1980;60:27–40.CrossRefGoogle Scholar
3.Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985;121:182–205.Google Scholar
4.Olson, MM, Lee, JT. Continuous, 10-year wound infection surveillance. Arch Surg 1990;125:794–803.Google Scholar
5.Glenister, HM, Taylor, LJ, Cooke, EM. A Surveillance Program of Surveillance Methods for Detecting Hospital Infection. London: PHLS; 1992.Google Scholar
6.Nosocomial Infection National Surveillance Scheme (NINSS). Surgical Site Infection: Analysis of a Year's Surveillance in English Hospitals: 1997-1998. London: PHLS; 2000.Google Scholar
7.Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol 1999;20:248–280.Google Scholar
8.Horan, TC, Gaynes, RP, Martone, WJ, Emori, TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound Infection. Infect Control Hosp Epidemiol 1992;13:606–608.Google Scholar
9.Daly, LE, Bourke, GJ, McGilvary, J. Interpretation and Uses of Medical Statistics, 4th ed. London: Blackwell Sciences; 1991.Google Scholar
10.Gastmeier, P, Kampf, G, Hauer, T, et al. Experience with two validation methods in a prevalence survey on nosocomial infections. Infect Control Hosp Epidemiol 1998;19:668–673.CrossRefGoogle Scholar
11.Cardo, DM, Falk, PS, Mayhall, GC. Validation of surgical wound surveillance. Infect Control Hosp Epidemiol 1993;14:211–215.CrossRefGoogle ScholarPubMed
12.Byrne, DJ, Lynch, W, Napier, A, Davey, P, Malek, M, Cuschieri, A. Wound infection rates: the importance of definition and post-discharge wound surveillance. J Hosp Infect 1994;26:37–43.Google Scholar
13.Weigelt, JA, Dryer, D, Haley, RW. The necessity and efficiency of wound surveillance after discharge. Arch Surg 1992;127:77–82.Google Scholar
14.Horan, TC, Culver, DH, Gaynes, RP, et al. Nosocomial infections in surgical patients in the United States, January 1986-June 1992. Infect Control Hosp Epidemiol 1993;14:73–80.CrossRefGoogle ScholarPubMed
15.Lizán-García, M, García-Caballero, J, Asensio-Vegas, A. Risk factors for surgical-wound infection in general surgery: a prospective surveillance program. Infect Control Hosp Epidemiol 1997;18:310–315.Google Scholar