Reduction of Surgical Site Infection Rates Associated With Active Surveillance

• Published in: Infection control and hospital epidemiology 2006-12, Vol.27 (12), p.1347-1351
• Main Authors: Brandt, C., Sohr, D., Behnke, M., Daschner, F., Rüden, H., Gastmeier, P.
• Format: Article
• Language: English
• Subjects: Arthroplasty; Biological and medical sciences; Cesarean section; Cholecystectomy; General aspects; Hip prostheses; Human infectious diseases. Experimental studies and models; Humans; Infection Control - methods; Infection Control - standards; Infections; Infectious diseases; Logistic Models; Logistic regression; Medical sciences; Miscellaneous; Nursing; Original Article; Patient surveillance; Population Surveillance - methods; Public health. Hygiene; Public health. Hygiene-occupational medicine; Regression Analysis; Retrospective Studies; Surgical procedures; Surgical specialties; Surgical Wound Infection - epidemiology; Surgical Wound Infection - prevention & control; Surveillance; Wound Infection - epidemiology; Wound Infection - microbiology; Wound Infection - prevention & control
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1086/509843

To evaluate whether surgical site infection (SSI) rates decrease in surgical departments as a result of performing active SSI surveillance. Retrospective multiple logistic regression analyses. A group of 130 surgical departments of German hospitals participating in the Krankenhaus Infektions Surveillance System (KISS). Data for 19 categories of operative procedures performed between January 1997 and June 2004 were included (119,114 operations). Active SSI surveillance was performed according to National Nosocomial Infections Surveillance system (NNIS) methods and definitions. Departments' SSI rates were calculated individually for each year of surveillance and for each operative procedure category, taking into account when the individual departments had begun their surveillance activities. Multiple logistic regression analyses on a single operation basis were carried out with stepwise variable selection to predict outcomes for patients with SSI. The variables included were as follows: the department's year of participation, NNIS risk index variables, patients' age and sex, and the hospitals' structural characteristics, such as yearly operation frequency, number of beds, and academic status. For 14 of 19 operative procedure categories analyzed, there was a tendency toward lower SSI rates that was associated with increasing duration of SSI surveillance. In multiple logistic regression analyses of pooled data for all operative procedures, the departments' participation in the surveillance system was a significant independent protective factor. Compared with the surveillance year 1, the SSI risk decreased in year 2 (odds ratio, 0.84; 95% confidence interval, 0.77-0.93) and in year 3 (odds ratio, 0.75; 95% confidence interval, 0.68-0.82), and there was no change in year 4. The SSI incidence was reduced by one quarter as a result of the surveillance-induced infection control efforts, which indicates the usefulness of a voluntary surveillance system.