Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

Anderson, Deverick J.; Podgorny, Kelly; Berríos-Torres, Sandra I.; Bratzler, Dale W.; Dellinger, E. Patchen; Greene, Linda; Nyquist, Ann Christine; Saiman, Lisa; Yokoe, Deborah S.; Maragakis, Lisa L.; Kaye, Keith S.

doi:10.1086/676022

Cited by 822 publications

(532 citation statements)

References 204 publications

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“…7 Most guidelines, including Therapeutic Guidelines: Antibiotic, recommend that preoperative intravenous antibiotics be given within 60 minutes of incision. 3,8,14,[31][32][33][34] More recently, the World Health Organization recommended administration within 120 minutes of incision. 35 For caesarean sections, evidence supports antimicrobial prophylaxis before cord clamping rather than afterwards.…”

Section: Resultsmentioning

confidence: 99%

Surgical antimicrobial prophylaxis

Ierano¹,

Nankervis²,

James³

et al. 2017

Aust Prescr

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Section: Resultsmentioning

confidence: 99%

Surgical antimicrobial prophylaxis

Ierano¹,

Nankervis²,

James³

et al. 2017

Aust Prescr

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“…SSI were defined using National Healthcare Safety Network criteria. 4 Prevalence rates for SSI were calculated as number of SSI per 100 procedures.…”

Section: Methodsmentioning

confidence: 99%

Seasonal Variation of Common Surgical Site Infections: Does Season Matter?

Durkin

Dicks

Baker

et al. 2015

Infect. Control Hosp. Epidemiol.

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OBJECTIVE To evaluate seasonal variation in the rate of surgical site infections (SSI) following commonly performed surgical procedures. DESIGN Retrospective cohort study. METHODS We analyzed 6 years (January 1, 2007, through December 31, 2012) of data from the 15 most commonly performed procedures in 20 hospitals in the Duke Infection Control Outreach Network. We defined summer as July through September. First, we performed 3 separate Poisson regression analyses (unadjusted, multivariable, and polynomial) to estimate prevalence rates and prevalence rate ratios of SSI following procedures performed in summer versus nonsummer months. Then, we stratified our results to obtain estimates based on procedure type and organism type. Finally, we performed a sensitivity analysis to test the robustness of our findings. RESULTS We identified 4,543 SSI following 441,428 surgical procedures (overall prevalence rate, 1.03/100 procedures). The rate of SSI was significantly higher during the summer compared with the remainder of the year (1.11/100 procedures vs 1.00/100 procedures; prevalence rate ratio, 1.11 [95% CI, 1.04–1.19]; P =.002). Stratum-specific SSI calculations revealed higher SSI rates during the summer for both spinal (P =.03) and nonspinal (P =.004) procedures and revealed higher rates during the summer for SSI due to either gram-positive cocci (P =.006) or gram-negative bacilli (P =.004). Multivariable regression analysis and sensitivity analyses confirmed our findings. CONCLUSIONS The rate of SSI following commonly performed surgical procedures was higher during the summer compared with the remainder of the year. Summer SSI rates remained elevated after stratification by organism and spinal versus nonspinal surgery, and rates did not change after controlling for other known SSI risk factors.

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“…In addition, the stress response to surgical insult results in insulin tolerance, and decreased pancreatic beta‐cell function causes hypo‐insulinemia, augmenting stress‐induced hyperglycemia 2. For the prevention of surgical site infections (SSI), appropriate perioperative insulin therapy is required in patients with hyperglycemia 3, 4, 5, 6, 7…”

Section: Introductionmentioning

confidence: 99%

Strict glycemic control to prevent surgical site infections in gastroenterological surgery

Takesue

Tsuchida

2017

Annals of Gastroent Surgery

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Perioperative hyperglycemia is a risk factor for surgical site infections (SSI). Although the recommended target blood glucose level (BG) is 140–180 mg/dL for critically ill patients, recent studies conducted in patients undergoing surgery showed a significant benefit of intensive insulin therapy for the management of perioperative hyperglycemia. The aim of the present review is to evaluate the benefits of strict glycemic control for reducing SSI in gastroenterological surgery. We carried out a post‐hoc analysis of the previously published data from research on the risk factors for SSI. The highest BG within 24 hours after surgery was evaluated. A total of 1555 patients were enrolled in the study. In multivariate analysis, a dose–response relationship between the level of hyperglycemia and the odds of SSI was demonstrated when compared with the reference group (≤150 mg/dL) (odds ratio [OR] = 1.68, 95% confidence interval [CI] 1.14–2.49 for 150–200 mg/dL; and OR = 2.15, 95% CI 1.40–3.29 for >200 mg/dL). Unexpectedly, hyperglycemia was not a significant risk factor for SSI among diabetes patients. By contrast, non‐diabetes patients with a BG of >150 mg/dL were found to have increased odds of SSI. In conclusion, a target BG of ≤150 mg/dL is recommended in patients without diabetes who undergo gastroenterological surgery. Additional study is required to determine an optimal target BG in diabetes patients. Because of the risk of hypoglycemia, a conventional protocol is indicated for patients admitted to the general ward where frequent glucose measurement is not assured.

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Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update

Cited by 822 publications

References 204 publications

Surgical antimicrobial prophylaxis

Surgical antimicrobial prophylaxis

Seasonal Variation of Common Surgical Site Infections: Does Season Matter?

Strict glycemic control to prevent surgical site infections in gastroenterological surgery

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