Post‐discharge surgical wound infection surveillance in a provincial hospital: Follow‐up rates, validity of data and review of the literature

Kent, P. J.; McDonald, Malcolm; Harris, Owen C.; Mason, Terry; Spelman, Denis

doi:10.1046/j.1445-2197.2001.02215.x

Cited by 51 publications

(29 citation statements)

References 42 publications

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“…Which of our fi ndings may be valid for other hospitals? First, approximately two-thirds of the SSIs were identifi ed after discharge, which is a noteworthy fi nding and is in agreement with other reports 5,[8][9][10] . In addition, the proportion of PD-SSI varied among specialties, another fi nding that has been previously reported 11 .…”

supporting

confidence: 80%

Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

Gomes

Cavalcante

Pavan

et al. 2014

Rev. Soc. Bras. Med. Trop.

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Introduction: Surgical site infections (SSIs) often manifest after patients are discharged and are missed by hospital-based surveillance. Methods: We conducted a case-reference study nested in a prospective cohort of patients from six surgical specialties in a teaching hospital. The factors related to SSI were compared for cases identifi ed during the hospital stay and after discharge. Results: Among 3,427 patients, 222 (6.4%) acquired an SSI. In 138 of these patients, the onset of the SSI occurred after discharge. Neurological surgery and the use of steroids were independently associated with a greater likelihood of SSI diagnosis during the hospital stay. Conclusions: Our results support the idea of a specialty-based strategy for post-discharge SSI surveillance.

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supporting

confidence: 80%

Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

Gomes

Cavalcante

Pavan

et al. 2014

Rev. Soc. Bras. Med. Trop.

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“…Considerando a tendência mundial em se reduzir cada vez mais a permanência hospitalar, as infecções de sítio cirúrgico extra-hospitalares dificilmente serão diagnosticadas caso não haja controle de egressos, uma vez que de 12% a 84% destas infecções manifestam-se após a alta do hospital 6,7,8,18,19,20 . No Brasil, entretanto, na maioria dos hospitais a vigilância das infecções de sítio cirúrgico é feita apenas durante a internação do paciente e é interrompida no momento da alta hospitalar 6,7 .…”

Section: Discussionunclassified

“…Apesar dos critérios para este tempo de seguimento e para a taxa de retorno dos pacientes não estarem bem definidos, a maioria dos autores preconiza trinta dias e um índice de acompanhamento maior que 80% 20 . Neste estudo, 98,6% dos pacientes da coorte foram acompanhados durante trinta dias.…”

Section: Discussionunclassified

Vigilância pós-alta das infecções de sítio cirúrgico em crianças e adolescentes em um hospital universitário de Belo Horizonte, Minas Gerais, Brasil

et al. 2008

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IntroduçãoAs infecções hospitalares podem ser atribuídas ao hospital e se manifestar durante a internação ou após a alta hospitalar. É notória a sua importância, pois aumentam a morbidade, mortalidade e os custos hospitalares, sendo as principais complicações nos pacientes cirúrgicos nos quais as infecções de sítio operatório são as mais freqüentes 1 .As infecções de sítio cirúrgico, anteriormente denominadas infecções de ferida operatória, acometem tecidos e órgãos incisados e cavidades manipuladas durante um procedimento cirúr-gico 2 . Sabe-se que um extensivo programa de vigilância pode reduzir as taxas de infecções de sítio cirúrgico em 30% a 40%, mas para que este programa seja efetivo deve-se conhecer a real incidência destas infecções e os fatores de risco associados 3 . As freqüências das infecções de sí-tio cirúrgico têm sido utilizadas como um importante indicador da performance dos cirurgiões e do hospital, sendo que o retorno dos dados da vigilância à equipe cirúrgica pode reduzir as taxas de infecção em até 35% 3,4 .Na vigilância das infecções de sítio cirúrgi-co, utiliza-se o componente cirúrgico do sistema de vigilância das infecções hospitalares National Nosocomial Infections Surveillance (NNIS) do Centers for Disease Control and Prevention (CDC, Estados Unidos) 5 , no qual os pacientes devem ser acompanhados até o 30 o dia do pós-ARTIGO ARTICLE

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“…The authors found a post-discharge infection rate of 8.38%, which is consistent with the findings of a review article that reported rates of 2-14%. [99] They also found strong statistical evidence that post-discharge surgical site infection (SSI) independently causes:…”

Section: Costs Incurred After Discharge Due To Surgical Site Infectionmentioning

confidence: 98%

Characterising health care‐associated bloodstream infections in public hospitals in Queensland, 2008–2012

Runnegar

Marquess

et al. 2016

Medical Journal of Australia

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Objective: To describe the epidemiology and rates of all health care‐associated bloodstream infections (HA‐BSIs) and of specific HA‐BSI subsets in public hospitals in Queensland. Design and setting: Standardised HA‐BSI surveillance data were collected in 23 Queensland public hospitals, 2008–2012. Main outcome measures: HA‐BSIs were prospectively classified in terms of place of acquisition (inpatient, non‐inpatient); focus of infection (intravascular catheter‐associated, organ site focus, neutropenic sepsis, or unknown focus); and causative organisms. Inpatient HA‐BSI rates (per 10 000 patient‐days) were calculated. Results: There were 8092 HA‐BSIs and 9418 causative organisms reported. Inpatient HA‐BSIs accounted for 79% of all cases. The focus of infection in 2792 cases (35%) was an organ site, intravascular catheters in 2755 (34%; including 2240 central line catheters), neutropenic sepsis in 1063 (13%), and unknown in 1482 (18%). Five per cent (117 of 2240) of central line‐associated BSIs (CLABSIs) were attributable to intensive care units (ICUs). Eight groups of organisms provided 79% of causative agents: coagulase‐negative staphylococci (18%), Staphylococcus aureus (15%), Escherichia coli (11%), Pseudomonas species (9%), Klebsiella pneumoniae/oxytoca (8%), Enterococcus species (7%), Enterobacter species (6%), and Candida species (5%). The overall inpatient HA‐BSI rate was 6.0 per 10 000 patient‐days. The rates for important BSI subsets included: intravascular catheter‐associated BSIs, 1.9 per 10 000 patient‐days; S. aureus BSIs, 1.0 per 10 000 patient‐days; and methicillin‐resistant S. aureus BSIs, 0.3 per 10 000 patient‐days. Conclusions: The rate of HA‐BSIs in Queensland public hospitals is lower than reported by similar studies elsewhere. About one‐third of HA‐BSIs are attributable to intravascular catheters, predominantly central venous lines, but the vast majority of CLABSIs are contracted outside ICUs. Different sources of HA‐BSIs require different prevention strategies.

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Post‐discharge surgical wound infection surveillance in a provincial hospital: Follow‐up rates, validity of data and review of the literature

Cited by 51 publications

References 42 publications

Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

Predictive factors of post-discharge surgical site infections among patients from a teaching hospital

Vigilância pós-alta das infecções de sítio cirúrgico em crianças e adolescentes em um hospital universitário de Belo Horizonte, Minas Gerais, Brasil

Characterising health care‐associated bloodstream infections in public hospitals in Queensland, 2008–2012

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