![]() |
|
Connected As: <Anonymous> Contact: srcosmos@aegean.gr |
Article summary:
| Keywords | Risk factors, Surgical site infection, Surveillance of SSIs. |
| Abstract | OBJECTIVE: The identification of risk factors for surgical site infections (SSIs) and the pathogenic microorganisms responsible in a tertiary general hospital in Greece. METHOD: The study was a cohort epidemiological survey which was conducted during the period October 2005-June 2006 at a University General Hospital in Greece. A total of 911 patients were included and 945 surgical operations were conducted during the study period. RESULTS: In total, 61 infections of the surgical site were detected in the 945 operations (6.5 infections/100 operations). The location of the infections was: 19 superficial incisional (31.1%), deep incisional 23 (37.7 %) and organ space 19 (31.1%). The most common microorganisms that were detected were Enterococcus faecium (17.9%), Enterococcus faecalis (11.8%), Escherichia coli and Pseudomonas aeruginosa (14.5%). Prophylactic antibiotic treatment had been administered for 61.6% of interventions. Risk factors that were found to affect the growth of SSIs were age >60 years old, hospitalization in the intensive care unit (ICU), multiple operations, the ASA score (2, 3, 4), long duration of the operation and the classification of the surgical wound; specifically, potentially infected wound, the risk index NNISS (1, 2, 3), a preoperative duration of hospitalization of >=48 hours, and prophylactic treatment with antibiotics. CONCLUSIONS: Although the use of prophylactic antibiotics is excessively high, the surgical patients in a Greek tertiary hospital suffer from high rates of SSI. The organization and operation of an appropriate protocol, the application of an information dissemination program and the modification of the growth factors of SSIs must comprise the future axis of intervention, with the objective of prevention of infection and thus, the promotion of health and the improvement of the quality of life of the surgical patients. |
| Full text | Full Text in PDF (201 KB) |
| Source link | http://www.mednet.gr/archives/2009-3/pdf/390.pdf |
| Included Refrences | 66 References (List...) |
| Cited by other Articles | 0 Citations (List...) |
| Name | Affiliation | Home page | Total pubs | |
| Fourmouzi M | Administrative and Economic School, ATEI of Crete, Greece | 1 | ||
| Grammatikopoulos ΙA | General Secretary of Social Welfare, Ministry of Health and Social Solidarity, Athens, Greece | 1 | ||
| Rikos N | University General Hospital of Heraklion, Greece | kalhmeranikos@yahoo.gr | 1 |
References included in article:
| Order of appearence | Full citation | SRCosmos Link |
| 1 | Consensus paper on the surveillance of surgical wound infections. 1992. The Society for Hospital Epidemiology of America; the Association for Practitioners in Infection Control; the Centers for Disease Control; the Surgical Infection Society. Infect Control Hosp Epidemiol, 13:599?605 | |
| 2 | Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG, 1992. CDC definitions of nosocomial surgical site infections, 1992: A modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol, 13:606?608 | |
| 3 | Jarvis WR, 2003. Benchmarking for prevention: The Centers for Disease Control and Prevention’s National Nosocomial Infections Surveillance (NNIS) system experience. Infection, 31(Suppl 2):44?48 | |
| 4 | Schifman RB, Howanitz PJ, 1994. Nosocomial infections. A college of American pathologists Q-probes study in 512 North American institutions. Arch Pathol Lab Med, 118:115?119 | |
| 5 | Gikas A, Pediaditis I, Roumbelaki M, Troulakis G, Romanos J, Tselentis Y, 1999. Repeated multi-centre prevalence surveys of hospital-acquired infection in Greek hospitals. CICNet. Cretan Infection Control Network. J Hosp Infect, 41:11?18 | |
| 6 | Gikas A, Pediaditis J, Papadakis JA, Starakis J, Levidiotou S, Nikolaides P, et al., 2002. Prevalence study of hospital-acquired infections in 14 Greek hospitals: Planning from the local to the national surveillance level. J Hosp Infect, 50:269?275 | |
| 7 | Gikas A, Roumbelaki M, Pediaditis J, Nikolaidis P, Levidiotou S, Kartali S, et al., 2004. Prevalence of nosocomial infections after surgery in Greek hospitals: Results of two nationwide surveys. Infect Control Hosp Epidemiol, 25:319?324 | |
| 8 | Wilson J, Ramboer I, Suetens C, 2007. Hospitals in Europe Link for Infection Control through Surveillance (HELICS). Inter-country comparison of rates of surgical site infection ? opportunities and limitations. J Hosp Infect, 65(Suppl 2):165?170 | |
| 9 | Nichols RL, 2004. Current strategies for prevention of surgical site infections. Curr Infect Dis Rep, 6:426?434 | |
| 10 | Simons BP, 1983. Guideline for prevention of surgical wound infections. Am J Infect Control, 11:133?143 | |
| 11 | Cruse PJ, Foord R, 1980. The epidemiology of wound infection. A 10-year prospective study of 62,939 wounds. Surg Clin North Am, 60:27?40 | |
| 12 | Cruse PJ, 1978. Feedback, technique reduce surgical infections. Hosp Infect Control, 5:113?114 | |
| 13 | Cruse P, 1981. Wound infection surveillance. Rev Infect Dis, 3:734?737 | |
| 14 | Cruse P, 1981. The epidemiology of wound infection in general sur gery. Aktuelle Probl Chir Orthop, 19:21?24 | |
| 15 | Kasatpibal N, Jamulitrat S, Chongsuvivatwong V, 2005. Standardized incidence rates of surgical site infection: A multicenter study in Thailand. Am J Infect Control, 33:587?594 | |
| 16 | Moro ML, Morsillo F, Tangenti M, Mongardi M, Pirazzini MC, Ragni P, 2005. Rates of surgical-site infection: An international comparison. Infect Control Hosp Epidemiol, 26:442?448 | |
| 17 | Kasatpibal N, Jamulitrat S, Chongsuvivatwong V, Norgard M, Sorensen HT, 2006. Impact of surgeon-specific feedback on surgical site infection rates in Thailand. J Hosp Infect, 63:148?155 | |
| 18 | Boni L, Benevento A, Rovera F, Dionigi G, Di-Giusepe M, Bertoglio C, et al., 2006. Infective complications in laparoscopic surgery. Surg Infect (Larchmt), 7(Suppl 2):S109?S111 | |
| 19 | Brummer S, Sohr D, Ruden H, Gastmeier P, 2007. Surgical site infection rates using a laparoscopic approach: Results of the German national nosocomial infections surveillance system. Chirurg, 8:910?914 | |
| 20 | Romy S, Eisenring MC, Bettschart V, Petignat C, Francioli P, Troillet N, 2008. Laparoscope use and surgical site infections in digestive surgery. Ann Surg, 247:627?632 | |
| 21 | Gaynes RP, Culver DH, Horan TC, Edwards JR, Richards C, Tolson JS. 2001. Surgical site infection (SSI) rates in the United States, 1992?1998: The National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis, 33(Suppl 2):S69?S77 | |
| 22 | Culver DH, Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG, et al., 1991. Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med, 91:152S?157S | |
| 23 | Maki DG, Bohn MJ, Stolz SM, Kroncke GM, Acher CW, Myerowitz PD, 1992. Comparative study of cefazolin, cefamandole, and vancomycin for surgical prophylaxis in cardiac and vascular operations. A double-blind randomized trial. J Thorac Cardiovasc Surg, 104:1423?1434 | |
| 24 | Johnson JT, Yu VL, Myers EN, Wagner RL, Sigler BA, 1986. Cefazolin vs moxalactam? A double-blind randomized trial of cephalosporins in head and neck surgery. Arch Otolaryngol Head Neck Surg, 112:151?153 | |
| 25 | Bauer T, Venits B, Holm B, Hahn-Pedersen J, Lysen D, Galatius H, et al., 1989. Antibiotic prophylaxis in acute non-perforated appendicitis. The Danish Multicenter Study Group III. Ann Surg, 209:307?311 | |
| 26 | Meijer WS, Schmitz PI, Jeekel J, 1990. Meta-analysis of randomized, controlled clinical trials of antibiotic prophylaxis in biliary tract surgery. Br J Surg, 77:283?290 | |
| 27 | Aznar R, Mateu M, Miro JM, Gatell JM, Gimferer JM, Aznar E, et al., 1991. Antibiotic prophylaxis in non-cardiac thoracic surgery: cefazolin versus placebo. Eur J Cardiothorac Surg, 5:515?518 | |
| 28 | Maki DG, Aughey DR, 1982. Comparative study of cefazolin, cefoxitin, and ceftizoxime for surgical prophylaxis in colo-rectal surgery. J Antimicrob Chemother, 10(Suppl C):281?287 | |
| 29 | Nichols RL, 1996. Surgical infections: Prevention and treatment1965 to 1995. Am J Surg, 172: 68?74 | |
| 30 | Nichols RL, Holmes JW, 1995. Prophylaxis in bowel surgery. Curr Clin Top Infect Dis, 15:76?96 | |
| 31 | Haines SJ, Walters BC, 1994. Antibiotic prophylaxis for cerebrospinal fluid shunts: A metanalysis. Neurosurgery, 34:87?92 | |
| 32 | Haines SJ, 1992. Antibiotic prophylaxis in neurosurgery. The controlled trials. Neurosurg Clin North Am, 3:355?358 | |
| 33 | Haines SJ, 1986. Antibiotic prophylaxis in neurosurgery. Clin Neurosurg, 33:633?642 | |
| 34 | Nichols RL, 1995. Surgical antibiotic prophylaxis. Med Clin North Am, 79:509?522 | |
| 35 | Starr MB, Laly JM, 1995. Antimicrobial prophylaxis for ophthalmic surgery. Surv Ophthalmol, 39:485?501 | |
| 36 | Ronveaux O, Mertens R, Dupont Y, 1996Surgical wound infection surveillance: Results from the Belgian hospital network. Acta Chir Belg, 96:3?10 | |
| 37 | Zacharias A, Habib RH, 1996. Delayed primary closure of deep sternal wound infections. Tex Heart Inst J, 23:211?216 | |
| 38 | Leaper D, Ayliffe GA, Gilchrist B, 1996. Postoperative wound infection. J Wound Care, 5:330?334 | |
| 39 | Rotter ML, 1988. A placebo-controlled trial of the effect of two preoperative baths or showers with chlorhexidine detergent on postoperative wound infection rates. J Hosp Infect, 12:137?138 | |
| 40 | Jodra VM, Diaz-Agero-perez C, Sainz-De-los-tereros-soler L, Saa-Requejo CM, Dacosta-Balesteros D, 1997. Results of the Spanish national nosocomial infection surveillance network (VICONOS) for surgery patients from January through December 2003. Am J Infect Control 2006, 34:134?141 | |
| 41 | Geubels EL, Mintjes –de-Groot A.J., van-den-Berg J.M., de-Boer A.S., 2000. An operating surveillance system of surgical-site infections in the Netherlands: Results of the PREZIES national surveillance network. Preventie van ziekenhuisinfecties door surveillance. Infect Control Hosp Epidemiol, 21:311?318 | |
| 42 | Rioux C, Grandbastien B, Astagneau P, 2007. Impact of a six-year control program on surgical site infections in France: Results of the INCISO surveillance. J Hosp Infect, 66:217?223 | |
| 43 | Clements AC, Tong EN, Morton AP, Whitby M, 2007. Risk stratification for surgical site infections in Australia: Evaluation of the US National Nosocomial Infection Surveillance risk index. J Hosp Infect, 66:148?155 | |
| 44 | Brown S, Kurtsi kashvili G., Alonso-Echanove J., Ghadua M., Ahmeteli L., Bochoidze T., et al., 2007. Prevalence and predictors of surgical site infection in Tbilisi, Republic of Georgia. J Hosp Infect, 66:160?166 | |
| 45 | Slaughter MS, Olson MM, Lee JTJ, Ward HB, 1993. A fifteen-year wound surveillance study after coronary artery bypass. Ann Thorac Surg, 56:1063?1068 | |
| 46 | Valentine RJ, Weigelt JA, Dryer D, Rodgers C, 1986. Effect of remote infections on clean wound infection rates. Am J Infect Control, 14:64?67 | |
| 47 | Nagachinta T, Stephens M, Reitz B, Polk BF, 1987. Risk factors for surgical-wound infection following cardiac surgery. J Infect Dis, 156:967?973 | |
| 48 | Gil-Egea MJ, Pi-Sunyer MT, Verdaguer A, Sanz F, Sitges-Sera A, Eleizegui LT, 1987. Surgical wound infections: Prospective study of 4,468 clean wounds. Infect Control, 8:277?280 | |
| 49 | Barber GR, Miransky J, Brown AE, Coit DG, Lewis FM, Thaler HT, et al., 1995. Direct observations of surgical wound infections at a comprehensive cancer center. Arch Surg, 130:1042?1047 | |
| 50 | Casey J, Flin WR, Yao JS, Fahey V, Pawlowski J, Bergan JJ, 1983. Correlation of immune and nutritional status with wound complications in patients undergoing vascular operations. Surgery, 93:822?827 | |
| 51 | Den-Broeder AA, Cremers MC, Fransen J, De-Jong E, De-Rooij DJ, Wymenga A, et al., 2007. Risk factors for surgical site infections and other complications in elective surgery in patients with rheumatoid arthritis with special attention for anti-tumor necrosis factor: A large retrospective study. J Rheumatol, 34:689?695 |