Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

• Published in: Infection control and hospital epidemiology 2012-06, Vol.33 (6), p.572-580
• Main Authors: Kim, Eu Suk, Kim, Hong Bin, Song, Kyoung-Ho, Kim, Young Keun, Kim, Hyung-Ho, Jin, Hye Young, Jeong, Sun Young, Sung, Joohon, Cho, Yong Kyun, Lee, Yeong-Seon, Oh, Hee-Bok, Kim, Eui-Chong, Kim, June Myung, Choi, Tae Yeol, Choi, Hee Jung, Kim, Hyo Youl, Korean Nosocomial Infections Surveillance System (KONIS)
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibiotic Prophylaxis - adverse effects; Antibiotics; Biological and medical sciences; Cephalosporins; Cross Infection - epidemiology; Cross Infection - etiology; Cross Infection - prevention & control; Female; General aspects; Human infectious diseases. Experimental studies and models; Humans; Indexing in process; Infection Control; Infections; Infectious diseases; Logistic Models; Male; Medical sciences; Middle Aged; Miscellaneous; Multivariate Analysis; Nursing; Original Article; Patient surveillance; Population Surveillance; Predisposing factors; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Reoperation; Republic of Korea - epidemiology; Risk Factors; Sex Factors; Stomach - surgery; Surgical procedures; Surgical specialties; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Surgical Wound Infection - prevention & control; Surveillance; Teaching hospitals
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1086/665728

Objective. To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea. Design. A nationwide prospective multicenter study. Setting. Twenty university-affiliated hospitals in Korea. Methods. The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models. Results. Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 (±12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms wereStaphylococcus aureusandKlebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09–2.58]), increased operation time (1.20 [1.07–1.34] per 1-hour increase), reoperation (7.27 [3.68–14.38]), combined multiple procedures (1.79 [1.13–2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09–8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26–5.64]) were independently associated with increased risk of SSI. Conclusions. Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.