Centers for Disease Control and Prevention 2017 Guidelines for Prevention of Surgical Site Infections: Review and Relevant Recommendations

Boyle, K. Keely; Rachala, Sridhar R.; Nodzo, Scott R.

doi:10.1007/s12178-018-9498-8

Cited by 44 publications

(20 citation statements)

References 81 publications

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“…The immune function of these young patients with SLE was comparative to the control group. The latest CDC guideline for prevention of SSI reviewed and concluded that the effect of steroid and immunosuppressive agent on the occurrence of SSI in prosthesis joint arthroplasty was uncertain [ 22 ]. Although the use of steroid, biologic agent, and DMARDs before joint replacement arthroplasty should be carefully evaluated and adjusted based on the 2017 American College of Rheumatology/American Association of Hip and Knee Surgeons Guideline to lower the potential adverse events, such as wound healing or SSI [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of systemic lupus erythematosus on the risk of infection after total hip arthroplasty: a nationwide population-based matched cohort study

Chen

Lin

et al. 2020

Arthritis Res Ther

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Background We aimed to assess the impact of systemic lupus erythematosus (SLE) on the risk of infection after total hip arthroplasty (THA). Methods We identified patients undergoing primary THA (1996–2013) in Taiwan National Health Insurance Research Database (NHIRD). Patients were then divided into the SLE and control groups according to the diagnosis of SLE. We used 1:1 propensity score to match the control to the SLE group by age, sex, and comorbidities. The primary outcome was infection, including early and late superficial wound infection and periprosthetic joint infection (PJI). The secondary outcome was in-hospital complications. Results We enrolled 325 patients in each group. In the primary outcome, the incidence of early superficial wound infection and PJI was comparable between the SLE and matched-control group. However, the incidence of late superficial wound infection and PJI in the SLE group was higher than that in matched-control group (11.4% vs. 5.5%, P = 0.01; 5.2% vs 2.2%, P = 0.04, respectively). Furthermore, the SLE group had a higher risk for late superficial wound infection and PJI (hazard ratio = 2.37, 95% confidence interval (CI) 1.35–4.16; HR = 2.74, 95% CI 1.14–6.64, respectively) than the matched-control. Complications other than infection and in-hospital mortality cannot be compared because of very low incidence. Conclusions SLE is a risk factor for developing late superficial wound infection and PJI, but not for early postoperative complications following THA. Clinical presentations should be monitored to avoid misdiagnosis of PJI in SLE patients after THA.

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Section: Discussionmentioning

confidence: 99%

The impact of systemic lupus erythematosus on the risk of infection after total hip arthroplasty: a nationwide population-based matched cohort study

Chen

Lin

et al. 2020

Arthritis Res Ther

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“… 5 13 A total of 446 and 582 patients were eligible for inclusion before and during the intervention studies, respectively. Among these, 62 and 49 patients with SSI within 30 days after surgery based on 2017 SSI criteria were defined by the Centers for Disease Control and Prevention 16 and identified by medical staff through a healthcare personnel-based survey and a patient-based telephone survey. 13 We included SSI from superficial, deep and organ space wounds, resulting from 11 surgical procedures related to thyroid, breast, colon, appendix, limb amputation, etc.…”

Section: Methodsmentioning

confidence: 99%

“…5 6 Published evidence suggests that the associated patient and hospital costs of SSI is about two times compared with patients without SSI. 7 8 A recent systemic review of the costs of SSI in 15 LMIC and 16 European countries finds that the additional attributable SSI cost is between US$174 and US$29 610 in LMIC and US$21 and US$34 000 in Europe. 9 Potential SSI-attributable cost savings may result from an effective intervention strategy, which minimises the risk of infection and the consequent additional LOS, and extra cost of care was provided to affected patients.…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: evidence from HAI-Ghana study

et al. 2022

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ObjectiveTo assess the cost-effectiveness of an active 30-day surgical site infection (SSI) surveillance mechanism at a referral teaching hospital in Ghana using data from healthcare-associated infection Ghana (HAI-Ghana) study.DesignBefore and during intervention study using economic evaluation model to assess the cost-effectiveness of an active 30-day SSI surveillance at a teaching hospital. The intervention involves daily inspection of surgical wound area for 30-day postsurgery with quarterly feedback provided to surgeons. Discharged patients were followed up by phone call on postoperative days 3, 15 and 30 using a recommended surgical wound healing postdischarge questionnaire.SettingKorle-Bu Teaching Hospital (KBTH), Ghana.ParticipantsAll prospective patients who underwent surgical procedures at the general surgical unit of the KBTH.Main outcome measuresThe primary outcome measures were the avoidable SSI morbidity risk and the associated costs from patient and provider perspectives. We also reported three indicators of SSI severity, that is, length of hospital stay (LOS), number of outpatient visits and laboratory tests. The analysis was performed in STATA V.14 and Microsoft Excel.ResultsBefore-intervention SSI risk was 13.9% (62/446) as opposed to during-intervention 8.4% (49/582), equivalent to a risk difference of 5.5% (95% CI 5.3 to 5.9). SSI mortality risk decreased by 33.3% during the intervention while SSI-attributable LOS decreased by 32.6%. Furthermore, the mean SSI-attributable patient direct and indirect medical cost declined by 12.1% during intervention while the hospital costs reduced by 19.1%. The intervention led to an estimated incremental cost-effectiveness ratio of US$4196 savings per SSI episode avoided. At a national scale, this could be equivalent to a US$60 162 248 cost advantage annually.ConclusionThe intervention is a simple, cost-effective, sustainable and adaptable strategy that may interest policymakers and health institutions interested in reducing SSI.

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“…Center of disease control (CDC) estimates an additional cost of $2,734 to $26,019 to the American health care system per SSI, with an annual figure estimated between $130million and $845million (8).…”

Section: Despite Advances Have Been Made In Infection Control Practicmentioning

confidence: 99%

Surgical site infection and predictors among adults in specialized hospital: prospective observational study

Kebede¹,

Asredaw²

2019

Preprint

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Introduction: Health-care-associated infection (HAI) is a major global safety issue for patients, health care managers and health-care professionals. One of HAI is surgical site infection (SSI). SSI is refers to an infection that occurs after surgery in the part of the body where surgery took place. It arises following surgery and is specifically related to the surgical site. It is estimated that SSIs account between 10-30% of all HAIs. Objective: The objectives of this study was to quantify the rate of wound infection and identify determinant factors Method: Prospective observational study was conducted from January to June 05/2019. All adult patients who met inclusion criteria were included in the study. The data was obtained either directly from the patient, or by observations or from the patient’s file. All patients were followed daily before, during and after operation for 30 days starting from the date of operation. Wound infection was detected at bedside and post-discharge surveillance. Chi-square test was computed to evaluate adequacy of cells for regression analysis. Independent predictors identified using binary logistic regression analysis and statistical significance was considered at p<0.05. Results: Two hundred eighty patients were included with mean age of 42.5±11 and 157(56.1%) patients were females. Caesarean section is the most common type of surgery. The rate of wound infection was found to be 80 (28.57%). The highest SSI rate was observed in gastrointestinal surgery 28(35.0). More than half of the cases were developed in health institution and patients having clean contaminated wound share the highest number. Majority of patients were undergoing emergency surgery with mean duration of surgery 1.8±0.65 hours. Multivariate analysis revealed that seven variables were significantly associated with the prevalence of wound infection; namely patient’s body mass index (P=0.037), age (P=0.046), history of previous surgery (P=0.04), preoperative hospital stay (p=0.0091), wound class (p=0.01) and history of steroid use (p= 0.027). Conclusion: In this study the rate of wound infection was high with patient’s physical status, duration of surgery, previous steroid use being strong predictor of infection. Life style modification is important to reduce body mass index and health professionals should counsel them.

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Centers for Disease Control and Prevention 2017 Guidelines for Prevention of Surgical Site Infections: Review and Relevant Recommendations

Cited by 44 publications

References 81 publications

The impact of systemic lupus erythematosus on the risk of infection after total hip arthroplasty: a nationwide population-based matched cohort study

The impact of systemic lupus erythematosus on the risk of infection after total hip arthroplasty: a nationwide population-based matched cohort study

Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: evidence from HAI-Ghana study

Surgical site infection and predictors among adults in specialized hospital: prospective observational study

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