National nosocomial infections surveillance system (NNIS): Description of surveillance methods

Emori, T. Grace; Culver, David H.; Horan, Teresa C.; Jarvis, William R.; White, Jennifer A.; Olson, David R.; Banerjee, Shailen N.; Edwards, Jonathan R.; Martone, William J.; Gaynes, Robert P.; Hughes, James M.

doi:10.1016/0196-6553(91)90157-8

Cited by 754 publications

(406 citation statements)

References 36 publications

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“…The program was developed according to the principles of the United States' NNIS system, currently named the National Healthcare Safety Network (NHSN). 11,12 Data extracted from the SSI surveillance database included type and incidence of SSI (per 1,000 operations), as well as causative micro-organisms, grouped yearly; patient characteristics such as age, gender, and American Society of Anesthesiology (ASA) physical status classification score; and procedure-related parameters such as type of procedure, M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 6 wound contamination class, duration of operation more than T time (T time is the length of time in hours that represents the 75 th percentile of procedures reported), time from admission to operation, emergency operation, and pre-operative antibiotic prophylaxis (latest dose prior to incision, within the 24 hours before incision). Appropriate timing of antibiotic administration was defined when given <1 h prior to incision.…”

Section: Methodsmentioning

confidence: 99%

Temporal trends and epidemiology of Staphylococcus aureus surgical site infection in the Swiss surveillance network: a cohort study

Abbas

Aghayev

Kuster³

et al. 2018

Journal of Hospital Infection

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Section: Methodsmentioning

confidence: 99%

Temporal trends and epidemiology of Staphylococcus aureus surgical site infection in the Swiss surveillance network: a cohort study

Abbas

Aghayev

Kuster³

et al. 2018

Journal of Hospital Infection

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“…SICU-acquired infection was confirmed according to the definitions established by CDC, and patient staphylococci were stored on preservation beads. 3 Staffing levels were not recorded. 4 Patients are routinely screened on admission and at weekly intervals for methicillin-resistant S. aureus (MRSA).…”

Section: Methodsmentioning

confidence: 99%

Are hygiene standards useful in assessing infection risk?

White

Dancer

Robertson

et al. 2008

American Journal of Infection Control

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“…Mean serum levels of IL-6 on POD 1 were significantly (88 vs. 34 pg/mL, P ϭ 0.034) higher in the group of patients with postoperative complications. The median postoperative hospital stay was 8 days (range, 5-39) in the control group and 6 days (range, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] in the steroid group (P ϭ 0.003).…”

Section: Postoperative Complications and Hospital Staymentioning

confidence: 99%

“…Infections were defined as positive culture of blood, sputum, or other fluids in the presence of clinical evidence of infection. 14 Adverse effects of chronic steroid use, such as abnormality in glucose tolerance and delay in wound healing, were evaluated.…”

Section: Clinical and Laboratory Variablesmentioning

confidence: 99%

Impact of preoperative steroids administration on ischemia-reperfusion injury and systemic responses in liver surgery: A prospective randomized study

et al. 2006

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Hepatic injury secondary to warm ischemia-reperfusion (I/R) injury and alterations in haemostatic parameters are often unavoidable events after major hepatic resection. The release of inflammatory mediator is believed to play a significant role in the genesis of these events. It has been suggested that preoperative steroid administration may reduce I/R injury and improve several aspects of the surgical stress response. The aim of this prospective randomized study was to investigate the clinical benefits on I/R injury and systemic responses of preoperatively administered corticosteroids. Seventy-six patients undergoing liver resection were randomized either to a steroid group or to a control group. Patients in the steroid group received preoperatively 500 mg of methylprednisolone. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, coagulation parameters, and inflammatory mediators, interleukin 6 and tumor necrosis factor alpha were compared between the 2 groups. Length of stay, and type and number of complications were recorded as well. Postoperative serum levels of ALT, AST, total bilirubin, and inflammatory cytokines were significantly lower in the steroid than in the control group at postoperative days 1 and 2. Changes in hemostatic parameters were also significantly attenuated in the steroid group. In conclusion, the incidence of postoperative complications in the steroid group tended to be significantly lower than the control group. It is of clinical interest that preoperative steroids administration before major surgery may reduce I/R injury, maintain coagulant/anticoagulant homeostasis, and reduce postoperative complications by modulating the inflammatory response. The human body reacts to surgical stimuli through various systemic responses including the endocrine, metabolic, coagulation, and immune systems. However, extended damage may result in an exaggerated systemic response with an overwhelming activation of immune cells and the release of various mediators of stress. [1][2][3] The systemic reaction to the operation is considered to be equivalent to the systemic inflammation response syndrome, mainly caused by cytokine networks. 4,5 Raised levels of inflammatory cytokines have been related to higher postoperative mortality and morbidity rates. 2,3,6 Therefore, increased attention has evolved toward modulating potentially deleterious inflammatory response to the operation.The anti-inflammatory and immune modulating effects of steroids have been known for decades and have found extensive therapeutic use in a wide range of diseases in which inflammatory responses play major role. 7,8 Several trials have investigated the benefits of administering corticosteroids as a modulator of cytokine response in patients undergoing elective cardiothoracic or gastrointestinal surgery, as well as in cases of septic shock, suggesting that several aspects of the surgical stress responses, organ dysfunction, and postAbbreviations: POD, postoperative day; ALT, alanine aminotr...

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National nosocomial infections surveillance system (NNIS): Description of surveillance methods

Cited by 754 publications

References 36 publications

Temporal trends and epidemiology of Staphylococcus aureus surgical site infection in the Swiss surveillance network: a cohort study

Temporal trends and epidemiology of Staphylococcus aureus surgical site infection in the Swiss surveillance network: a cohort study

Are hygiene standards useful in assessing infection risk?

Impact of preoperative steroids administration on ischemia-reperfusion injury and systemic responses in liver surgery: A prospective randomized study

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