Effect of intensive surveillance on cesarean-section wound infection rate in a Saudi Arabian hospital

Abstract

Surveillance for surgical site infection (SSI) in cesarean-section (C-section) in our hospital, carried out between September 1998 and July 1999, identified areas of deficiency in aseptic techniques that have contributed to increased incisional surgical site infection rates (ISSI) rates. On the basis of these findings, we intensified the infection control presence in this area and increased the number of in-services to our staff, with attention to infection control practices. Our senior infection control staff carried out ongoing monitoring of the ISSI rates as well as careful observation of aseptic technique. The aim was to reduce the rates of C-section ISSI in our hospital. We used the Centers for Disease Control and Prevention definitions for infection and the National Nosocomial Infections Surveillance System (NNISS) risk index in measuring the ISSI rates in the 2 time periods. We compared the ISSI rates with those of our preintervention period in an attempt to evaluate our interventional measures. Eight hundred seventy-five (875) C-sections were performed at King Fahad National Guard Hospital between January and December 2000. The overall ISSI rate was 1.37%. The ISSI rate for the NNISS risk category 0 (zero) was 1.2% and for the NNISS risk category 1 was 4.1%. There was a 50% reduction in the overall ISSI rates from our preintervention period (P <.05). Even though there were no objective means by which we measured the effect of infection control presence on the asepsis practices, there were no other changes that could have attributed to this significant reduction in ISSI rates in our C-section population. (Am J Infect Control 2003;31:288-90.)