The Effect of Increasing Age on the Risk of Surgical Site Infection

Kaye, Keith S.; Schmit, Kristine M; Pieper, Carl F.; Sloane, Richard; Caughlan, Kathleen F.; Sexton, Daniel J.; Schmader, Kenneth E.

doi:10.1086/428626

Cited by 201 publications

(138 citation statements)

References 36 publications

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“…The SSI incidence in our Hospital has dropped dramatically over the years, from 8.8% in 1994 to 3.3% in 2003. Other authors have reported incidences of 1.2% [18], 4.4% [19], 5.7% [20], 6.2% [21], and up to 12% [22].…”

Section: Discussionmentioning

confidence: 99%

Surgical site infection in a university hospital in northeast Brazil

Medeiros¹,

Aires-Neto²,

Azevedo³

et al. 2005

Braz J Infect Dis

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We examined prevention of surgical site infection (SSI) in a tertiary teaching hospital in northeast Brazil, from January 1994 to December 2003. The survey included 5,742 patients subjected to thoracic, urologic, vascular and general surgery. The criteria for diagnosing SSI were those of the Centers for Disease Control, USA, and the variables of the National Nosocomial Infection Surveillance risk index were used. Data analysis revealed that anesthetic risk scores, wound class and duration of surgery were significantly associated with SSI. A total of 296 SSIs were detected among the 5,742 patients (5.1%). The overall incidence of SSI was 8.8% in 1994; it decreased to 3.3% in 2003. In conclusion, the use of educational strategies, based on guidelines for SSI prevention reduced SSI incidence. Appropriate management of preoperative, intraoperative, and postoperative incision care, and a surveillance system based on international criteria, were useful in reducing SSI rates in our hospital.

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Section: Discussionmentioning

confidence: 99%

Surgical site infection in a university hospital in northeast Brazil

Medeiros¹,

Aires-Neto²,

Azevedo³

et al. 2005

Braz J Infect Dis

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“…Both of these surgical surveillance databases have been previously described and validated. 14,15 These databases included operative variables, such as patient age, date of surgical procedure, type of procedure, and National Healthcare Safety Network (NHSN) risk index variables (ie, wound class, American Society of Anesthesiologists [ASA] score, and length of procedure). 16 For patients with SSI, the following data were obtained: type of SSI (ie, superficial incisional, deep incisional, or organ/space), causative pathogen, pathogen susceptibility to antibiotics, date of infection, and anatomic site of culture sampling.…”

Section: Study Design and Participating Centersmentioning

confidence: 99%

“…The median time to onset of S. aureus SSI after surgery was 19 days (IQR, [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28], whereas the time to onset of S. aureus BSI was 18 days (IQR, 10-44).…”

Section: Overall Study Populationmentioning

confidence: 99%

Variation in the Type and Frequency of Postoperative Invasive Staphylococcus aureus Infections According to Type of Surgical Procedure

Anderson

Arduino

Reed

et al. 2010

Infect. Control Hosp. Epidemiol.

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Objective.To determine the epidemiological characteristics of postoperative invasive Staphylococcus aureus infection following 4 types of major surgical procedures.Design.Retrospective cohort study.Setting.Eleven hospitals (9 community hospitals and 2 tertiary care hospitals) in North Carolina and Virginia.Patients.Adults undergoing orthopedic, neurosurgical, cardiothoracic, and plastic surgical procedures.Methods.We used previously validated, prospectively collected surgical surveillance data for surgical site infection and microbiological data for bloodstream infection. The study period was 2003 through 2006. We defined invasive S. aureus infection as either nonsuperficial incisional surgical site infection or bloodstream infection. Nonparametric bootstrapping was used to generate 95% confidence intervals (CIs). P values were generated using the Pearson x2 test, Student t test, or Wilcoxon rank-sum test, as appropriate.Results.In total, 81,267 patients underwent 96,455 procedures during the study period. The overall incidence of invasive S. aureus infection was 0.47 infections per 100 procedures (95% CI, 0.43–0.52); 227 (51%) of 446 infections were due to methicillin-resistant S. aureus. Invasive S. aureus infection was more common after cardiothoracic procedures (incidence, 0.79 infections per 100 procedures [95% CI, 0.62–0.97]) than after orthopedic procedures (0.37 infections per 100 procedures [95% CI, 0.32–0.42]), neurosurgical procedures (0.62 infections per 100 procedures [95% CI, 0.53–0.72]), or plastic surgical procedures (0.32 infections per 100 procedures [95% CI, 0.17¬0.47]) (P < .001). Similarly, S. aureus bloodstream infection was most common after cardiothoracic procedures (incidence, 0.57 infections per 100 procedures [95% CI, 0.43–0.72]; P < .001, compared with other procedure types), comprising almost three-quarters of the invasive S. aureus infections after these procedures. The highest rate of surgical site infection was observed after neurosurgical procedures (incidence, 0.50 infections per 100 procedures [95% CI, 0.42–0.59]; P < .001, compared with other procedure types), comprising 80% of invasive S. aureus infections after these procedures.Conclusion.The frequency and type of postoperative invasive S. aureus infection varied significantly across procedure types. The highest risk procedures, such as cardiothoracic procedures, should be targeted for ongoing preventative interventions.

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“…27 Another unexpected finding is the fact that "dirtier" wounds (i.e. increases in wound contamination class) were associated with decreased risk of S. aureus SSI.…”

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confidence: 99%