Severe Surgical Site Infection in Community Hospitals: Epidemiology, Key Procedures, and the Changing Prevalence of Methicillin-Resistant Staphylococcus aureus

2007 ◽  
Vol 28 (9) ◽  
pp. 1047-1053 ◽  
Author(s):  
Deverick J. Anderson ◽  
Daniel J. Sexton ◽  
Zeina A. Kanafani ◽  
Grace Auten ◽  
Keith S. Kaye
Keyword(s):  
Surgical Site Infection ◽  
Prevalence Rate ◽  
Site Infection ◽  
Prevalence Rates ◽  
Community Hospitals ◽  
Methicillin Resistant ◽  
The Past ◽  
Prevalence Rate Ratio ◽  
Trend Data ◽  
A Prospective Study

Objective.To characterize the epidemiology of severe (ie, nonsuperficial) surgical site infection (SSI) in community hospitals.Methods.SSI data were collected prospectively at 26 community hospitals in the southeastern United States. Two analyses were performed: (1) a study of the overall prevalence rates of SSI and the prevalence rates of SSI due to specific pathogens in 2005 at all participating hospitals and (2) a prospective study of consecutive surgical procedures at 9 of the 26 community hospitals from 2000 through 2005.Results.In 2005, a total of 1,010 SSIs occurred after 89,302 procedures (prevalence rate, 1.13 infections per 100 procedures). Methicillin-resistant S. aureus (MRSA) was the pathogen most commonly recovered (from 175 SSIs). Trend data from 2000 through 2005 demonstrated that the prevalence rate of MRSA SSI almost doubled during this period, increasing from 0.12 infections per 100 procedures (95% confidence interval [CI], 0.12-0.13) to 0.23 infections per 100 procedures (95% CI, 0.22-0.24) (P<.0001). In adjusted analysis, MRSA SSI was significantly more prevalent at the end of the study period than at the beginning (prevalence rate ratio, 1.48 [95% CI, 1.36-1.61]; P<.0001).Conclusions.MRSA was the pathogen that most commonly caused SSI in our network of community hospitals during 2005. The prevalence of MRSA SSI has increased significantly over the past 6 years.

scholarly journals Epidemiology of Surgical Site Infection in a Community Hospital Network

2016 ◽  
Vol 37 (5) ◽  
pp. 519-526 ◽  
Author(s):  
Arthur W. Baker ◽  
Kristen V. Dicks ◽  
Michael J. Durkin ◽  
David J. Weber ◽  
Sarah S. Lewis ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Prevalence Rate ◽  
Colon Surgery ◽  
Causative Organism ◽  
Site Infection ◽  
Prevalence Rates ◽  
Community Hospitals ◽  
Bowel Surgery ◽  
Prevalence Rate Ratio ◽  
Over Time

OBJECTIVETo describe the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogensMETHODSWe prospectively collected SSI data at 29 community hospitals in the southeastern United States from 2008 through 2012. We determined the overall prevalence rates of SSI for commonly performed procedures during this 5-year study period. For each year of the study, we then calculated prevalence rates of SSI stratified by causative organism. We created log-binomial regression models to analyze trends of SSI prevalence over time for all pathogens combined and specifically for MRSA.RESULTSA total of 3,988 complex SSIs occurred following 532,694 procedures (prevalence rate, 0.7 infections per 100 procedures). SSIs occurred most frequently after small bowel surgery, peripheral vascular bypass surgery, and colon surgery. Staphylococcus aureus was the most common pathogen. The prevalence rate of SSI decreased from 0.76 infections per 100 procedures in 2008 to 0.69 infections per 100 procedures in 2012 (prevalence rate ratio [PRR], 0.90; 95% confidence interval [CI], 0.82–1.00). A more substantial decrease in MRSA SSI (PRR, 0.69; 95% CI, 0.54–0.89) was largely responsible for this overall trend.CONCLUSIONSThe prevalence of MRSA SSI decreased from 2008 to 2012 in our network of community hospitals. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence over the study period.Infect Control Hosp Epidemiol 2016;37:519–526

EFFICACY OF ANTIBIOTICS PROPHYLAXIS IN PATIENTS WITH LUMBAR DISC HERNIATION UNDERGOING LUMBAR DISCETOMY

2018 ◽  
Vol 8 (5) ◽  
pp. 14-19
Author(s):  
Tri Truong Van ◽  
Tri Tran Duc Duy ◽  
Khai Vo Le Quang
Keyword(s):  
Surgical Site Infection ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lumbar Disc ◽  
Lumbar Discectomy ◽  
University Hospital ◽  
Site Infection ◽  
Surgical Wound ◽  
A Prospective Study ◽  
Length Of Hospitalization

Introduction: Surgical wound infection in developing coutries is about 3%. Antibiotics prophylaxis may help to reduce the surgical site infection. The objective of this study was to evaluate the efficacy of antibiotics prophylaxis in patients with lumbar disc herniation who were treated with lumbar discectomy at Hue University hospital. Materials and Methods: A prospective study was conducted at Hue University hospital from March 2015 to May 2018 on 54 patients with lumbar disc herniation who were used antibiotics prophylaxis when undergoing discectomy. Results: The infection rate in our study was 0%. Antibiotics prophylaxis reduced the length of hospitalization as well as the medical cost. Conclusion: Antibiotics prophylaxis was effective in preventing surgical site infection despite the fact that the condition of operating rooms did not meet the standard rules. Key words: prophylaxis antibiotics, lumbar disc herniation

scholarly journals Risk factors for surgical site infection in a teaching hospital: a prospective study of 1,138 patients

2015 ◽  
pp. 1171 ◽  
Author(s):  
Xia Guohua ◽  
keping cheng ◽  
Jiawei Li ◽  
Qingfang Kong ◽  
Changxian Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Study ◽  
Surgical Site Infection ◽  
Teaching Hospital ◽  
Site Infection ◽  
A Prospective Study

scholarly journals MRSA – ‘Bug-Bear’ of a Surgical Practice: Reducing the Incidence of MRSA Surgical Site Infections

2006 ◽  
Vol 88 (2) ◽  
pp. 222-223 ◽  
Author(s):  
Andrea Guyot ◽  
Graham Layer
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Orthopaedic Surgery ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Infection Rates ◽  
Methicillin Resistant ◽  
Surgical Practice ◽  
Department Of Health

Adverse publicity (the ‘superbug') has demonstrated that the problem of MRSA (methicillin-resistant Staphylococcus aureus) is prevalent in many of the country's most prestigious hospitals. The results of the mandatory UK Department of Health (DH) surveillance for early surgical site infections in orthopaedic surgery (SSIS) have been published recently for the period April 2004 to March 2005 when 41,242 operations were studied (< http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsStatistic > 28 October 2005). Infection rates were generally and gratifyingly low but 48% of surgical site infections were caused by Staph. aureus and of those 68% were MRSA. The following article will discuss the aetiology and prevention of MRSA surgical site infection.

scholarly journals Incidence and risk factors for surgical site infection following elective foot and ankle surgery: a retrospective study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jinghong Meng ◽  
Yanbin Zhu ◽  
Yansen Li ◽  
Tao Sun ◽  
Fengqi Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Retrospective Study ◽  
Surgical Site Infection ◽  
Elective Surgery ◽  
Site Infection ◽  
Foot And Ankle ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Associated Risk Factors

Abstract Background This study aimed to investigate the incidence of surgical site infection (SSI) in elective foot and ankle surgeries and identify the associated risk factors. Methods This was designed as a retrospective study, including patients who underwent elective surgery of foot and ankle between July 2015 and June 2018. Data on demographics, comorbidities, and perioperative parameters were collected from the medical records, the laboratory report, the operation report, and the outpatient follow-up registration database. SSI was defined in accordance with the Center for Disease Control criteria. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for SSI. Results A total of 1201 patients undergoing 1259 elective foot/ankle surgeries were included, of whom 26 (2.1%) had an SSI, representing an incidence rate of 1.3% for superficial SSI and 0.8% for deep SSI, respectively. The results for organism culture showed Pseudomonas aeruginosa in 7 cases, methicillin-resistant Staphylococcus aureus (MRSA) in 6, methicillin-susceptible Staphylococcus aureus (MSSA) in 5, methicillin-resistant coagulase-negative Staphylococci (MRCNS) in 2, Escherichia coli in 2, and Proteus mirabilis in 1 case. Five factors were identified to be independently associated with SSI, including prolonged preoperative stay (OR, 1.21; 95% CI, 1.09 to 1.30), allograft or bone substitute (OR, 3.76; 95% CI, 1.51 to 5.30), elevated FBG level (OR, 1.17; 95% CI, 1.04 to 1.26), lower ALB level (OR, 2.33; 95% CI, 1.19 to 3.05), and abnormal NEUT count (OR, 1.72; 95% CI, 1.27 to 2.12). Conclusions SSI following elective foot and ankle surgeries is low, but relatively high in forefoot surgeries, requiring particular attention in clinical practice. Although most not modifiable, these identified factors aid in risk assessment of SSI and accordingly stratifying patients and therefore should be kept in mind.

Poor Functional Status as a Risk Factor for Surgical Site Infection Due to Methicillin-Resistant Staphylococcus aureus

2008 ◽  
Vol 29 (9) ◽  
pp. 832-839 ◽  
Author(s):  
Deverick J. Anderson ◽  
Luke F. Chen ◽  
Kenneth E. Schmader ◽  
Daniel J. Sexton ◽  
Yong Choi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Functional Status ◽  
Surgical Patients ◽  
Control Group ◽  
Site Infection ◽  
Methicillin Resistant ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
Poor Functional Status

Objective.To identify risk factors for surgical site infection (SSI) due to methicillin-resistant Staphylococcus aureus (MRSA).Design.Prospective case-control study.Setting.One tertiary and 6 community-based institutions in the southeastern United States.Methods.We compared patients with SSI due to MRSA with 2 control groups: matched uninfected surgical patients and patients with SSI due to methicillin-susceptible S. aureus (MSSA). Multivariable logistic regression was used to determine variables independently associated with SSI due to MRSA, compared with each control group.Results.During the 5-year study period, 150 case patients with SSI due to MRSA were identified and compared with 231 matched uninfected control patients and 128 control patients with SSI due to MSSA. Two variables were independendy associated with SSI due to MRSA in both multivariable regression models: need for assistance with 3 or more activities of daily living (odds ratio [OR] compared with uninfected patients, 3.97 [95% confidence interval {CI}, 2.18-7.25]; OR compared with patients with SSI due to MSSA, 3.88 [95% CI, 1.91-7.87]) and prolonged duration of surgery (OR compared with uninfected patients, 1.98 [95% CI, 1.11-3.55]; OR compared with patients with SSI due to MSSA, 2.33 [95% CI, 1.17-4.62]). Lack of independence (ie, poor functional status) remained associated with an increased risk of SSI due to MRSA after stratifying by age.Conclusions.Poor functional status was highly associated with SSI due to MRSA in adult surgical patients, regardless of age. A patient's level of independence can be easily determined, and this information can be used preoperatively to target preventive interventions.

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