Five-year decreased incidence of surgical site infections following gastrectomy and prosthetic joint replacement surgery through active surveillance by the Korean Nosocomial Infection Surveillance System

Choi, Hee Jung; Adiyani, L.; Sung, Jae Kyu; Choi, Jun Yong; Kim, H. B.; Kim, Y. K.; Kwak, Yee Gyung; Yoo, Hyung Joun; Lee, Sang‐Oh; Han, Su Ha; Kim, S. R.; Kim, T. H.; Lee, H. M.; Chun, Hye‐Yeong; Kim, J. S.; Yoo, Jae-Doo; Koo, Hyun; Cho, E. H.; Lee, K. W.

doi:10.1016/j.jhin.2015.12.021

Cited by 37 publications

(21 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a survey which was conducted in Korea, the incidence of SSI following gastrectomy was 3.12%. 17 Another research demonstrated that the monthly incidence rates varied between 4.14 and 6.61 per 1000 bed-days for UTI and between 0.09 and 1.25 per 1000 bed-days for BSI. 18 This indicated the higher incidence of nosocomial infection in our survey compared to other studies.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of mortality in nosocomial infected traumatic patients in a trauma referral center in south of Iran

Yadollahi

Kashkooe

Feyzi

et al. 2018

Chinese Journal of Traumatology

View full text Add to dashboard Cite

PurposeTrauma-related injuries are the leading cause of death worldwide. Some risk factors make traumatic patients susceptible to infection. Furthermore, some mortality risk factors, including length of hospitalization and increasing age, were detected in non-traumatic infected patients. This study aimed to assess mortality risk factors among nosocomial infected traumatic patients in Rajaee trauma center, Shiraz, Iran.MethodsThis prospective cohort study was conducted during a period of 2 years since April 2015 to March 2017 in Rajaee hospital, which is the center of emergency medical services for traumatic injuries in Shiraz, Iran. Centers for Disease Control and Prevention/National Healthcare Safety Network surveillance system criteria were applied to define 5 types of nosocomial infections. The variables analyzed as the risk factors of infection and mortality included sex, age, mechanism of injury, site of injury, injury severity score (ISS), surgical intervention, length of hospitalization, intensive care unit (ICU) admission, and type of pathogen. Then, the incidence of nosocomial infection and also risk factors of mortality in traumatic patients were evaluated. All data analyses were performed using the statistical package for social sciences, version 15 (SPSS Inc., Chicago) and p ≤ 0.05 is considered to be statistically significant.ResultsThe incidence of nosocomial infection was 7.2% (p < 0.001). Pneumonia was the most common type of infection detected in our study. Infection led to a 7.8-fold increase in mortality of the traumatic patients (p < 0.001). Admission in intensive care units and old age were the main risk factors of mortality in infected traumatic patients. Old age, gunshot and motor vehicle accidents, trauma to extremities and abdomen, higher injury severity score, and prolonged hospitalization, made the traumatic patients more susceptible to infection.ConclusionThe really high incidence of nosocomial infection in traumatic patients in Iran depends on some risk factors that should be considered. Also infection increases the mortality rate in the traumatic patients, which could be reduced by eliminating its risk factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk factors of mortality in nosocomial infected traumatic patients in a trauma referral center in south of Iran

Yadollahi

Kashkooe

Feyzi

et al. 2018

Chinese Journal of Traumatology

View full text Add to dashboard Cite

show abstract

“…The World Health Organization reports that the incidence of SSI is 6.0% in low-income countries and 7.8% in Southeast Asian countries, both of which are higher than those of countries such as the United States and Australia where the incidence rates are 0.9 and 2.8%, respectively [6]. Further, a systematic review of Korean studies showed that the incidence of SSI in Korea ranges between 2 and 9.7% [7], and according to data from the Korean Nosocomial Infection Surveillance System (KONIS) between 2008 and 2012, the SSI rate following gastrectomy was 3.12%, that for total hip arthroplasty was 2.05%, and that for total knee arthroplasty was 1.90% [8], all of which are higher than the rates that have been recorded in other countries; therefore, there is a need for nationwide efforts to lower the incidence of SSI.…”

Section: Introductionmentioning

confidence: 99%

National hospital quality measures for surgical site infections in South Korea: a survey among 20 expert physicians

2020

View full text Add to dashboard Cite

Background: Surgical site infection (SSI) is recognized as an important quality indicator for patient safety. In Korea, the use of prophylactic antibiotics for surgery is conducted as a national quality measures related to SSI prevention. The objective of the present study was to investigate physicians' perceptions of hospital quality measures for SSI as well as identify obstacles that might hinder its implementation in South Korea. Method: Online-based questionnaires were administered twice. Twenty physician experts who were members of the Healthcare Review and Assessment Committee that was constituted for the "Assessment of prophylactic use of antibiotics for surgery" participated in the study. The first survey comprised open-ended questions that were designed to elicit the physician who could hinder the implementation of SSI indicators. The second survey, which was developed on the basis of the initial survey's results, consisted of 10 closed-ended questions about the feasibility of objective perception and the need for subjectivity, with regard to SSI. Results: From among the 20 physicians, we collected data from 16 respondents in the first survey (response rate of 80%) and 15 respondents in the second survey (response rate of 75%).Thirty-one percent of the respondents supported hospital SSI evaluations, and 69% expressed objections. The obstacles that were perceived as being able to hinder hospital SSI evaluations pertained to difficulties in collecting data, unavailability of information, possibility of underreporting, and redundancy of the inquiry undertaken by the Korean National Healthcare-associated Infections Surveillance System-SSI. Physician experts provide significantly higher ratings for the clinical indicator, rate of readmission due to SSI, both in terms of feasibility and need, when evaluating the results of SSI prevention in hospitals. Conclusion: The results of this study show that physicians perceive the need for QI development of hospital SSI measurements to prevent nationwide SSIs in Korea. However, the feasibility of hospital SSI measurements is low. To develop QIs of hospital SSIs using health insurance claims data, it is necessary to develop a methodology for claims data-based surveillance systems and a data collection system in order to increase the sensitivity and validity of post-operative SSI detection.

show abstract

“…We were successful in significantly reducing the incidence rate of SSI after spinal instrumentation surgery through a combination of surveillance, implemented by an ICT, and intrawound application of vancomycin powder. Following the American study on the efficacy of nosocomial infection control (SENIC project), [ 23 ] active surveillance was implemented in Europe, [ 10 , 24 – 28 ] Australia, [ 29 ] and Asia, [ 30 , 31 ] and has played an important role in the prevention of SSIs. Although most surveillance programs have been effective in reducing the rate of SSI, surveillance alone was insufficient in our study.…”

Section: Discussionmentioning

confidence: 99%

Decreased rate of surgical site infection after spinal surgery with instrumentation using bundled approach including surveillance and intrawound vancomycin application

et al. 2018

View full text Add to dashboard Cite

Surgical site infections (SSIs) increase the risk of mortality, postsurgery, extend hospital stay, and increase the costs of healthcare. Our aim in this study was to evaluate the effectiveness of a multidisciplinary, evidence-based, surveillance program combined with intrawound application of vancomycin in lowering the incidence rate of SSI after spinal surgery with instrumentation.We conducted a retrospective analysis of 637 patients who underwent spinal fusion with instrumentation in our institution at 3 different time periods: prior to our surveillance program (control group), surveillance only (surveillance group 1), and surveillance combined with intrawound vancomycin application (surveillance group 2). The following covariates were considered in the evaluation of between-group differences in SSI rate: sex, age, surgical site, National Nosocomial Infection Surveillance (NNIS) risk index, American Society of Anesthesiologists (ASA) physical status classification, and other health comorbidities. The causative organism in cases of SSI was confirmed in all cases.The rate of SSI was significantly lower in the surveillance group 2 (1.4%) than in the control group (4.6%; P = .04). On multivariate logistic regression analysis, steroid use (adjusted odd's ratio (OR), 6.06; 95% confidence interval (CI), 1.45–23.6) and operative time (adjusted OR.1.01; 95% CI, 1.00–1.01) were identified as independent risk factors of SSI. Staphylococcus species and Propionibacterium acnes were the principal causative organisms.A bundled approach that includes surveillance and intrawound application of vancomycin is an effective strategy to lower the risk of SSI after spinal fusion with instrumentation. The use of steroid and longer operative time are risk factors of SSI.Our findings support the implementation of a program of surveillance, combined with intrawound vancomycin application, to reduce the incidence rate of SSIs in spinal surgery.

show abstract

Five-year decreased incidence of surgical site infections following gastrectomy and prosthetic joint replacement surgery through active surveillance by the Korean Nosocomial Infection Surveillance System

Cited by 37 publications

References 15 publications

Risk factors of mortality in nosocomial infected traumatic patients in a trauma referral center in south of Iran

Risk factors of mortality in nosocomial infected traumatic patients in a trauma referral center in south of Iran

National hospital quality measures for surgical site infections in South Korea: a survey among 20 expert physicians

Decreased rate of surgical site infection after spinal surgery with instrumentation using bundled approach including surveillance and intrawound vancomycin application

Contact Info

Product

Resources

About