National Surgical Site Infection Surveillance Research Articles

The provision of infection prevention and control services in the public health sector in New Zealand

Infection prevention and control services are well established within publically funded hospitals within New Zealand. In 2007, the Ministry of Health Quality Improvement Committee developed a set of National Quality Improvement Programs including an Infection Prevention and Control project. This project, the implementation of a national hand hygiene program, provision of guidance to reduce central line associated bacteraemia and recommendations for a national surgical site infection surveillance program, was the first nationally coordinated infection prevention and control program. More recently the Health Quality and Safety Commission has been established and the responsibility of the program delivery shifted to the Commission. District Health Boards have agreed to participate in the programs and the recently introduced Quality and Safety Markers will track the progress of these programs. Ongoing committed to increasing the workforce capacity and capability is required to ensure the successful delivery of these programs.

Reducing surgical site infection incidence through a network: results from the French ISO-RAISIN surveillance system

Surgical-site infections (SSIs) are a key target for nosocomial infection control programmes. We evaluated the impact of an eight-year national SSI surveillance system named ISO-RAISIN (infection du site opératoire - Réseau Alerte Investigation Surveillance des Infections). Consecutive patients undergoing surgery were enrolled during a three-month period each year and surveyed for 30 days following surgery. A standardised form was completed for each patient including SSI diagnosis according to standard criteria, and several risk factors such as wound class, American Society of Anesthesiologists (ASA) score, operation duration, elective/emergency surgery, and type of surgery. From 1999 to 2006, 14,845 SSIs were identified in 964,128 patients (overall crude incidence: 1.54%) operated on in 838 participating hospitals. The crude overall SSI incidence decreased from 2.04% to 1.26% (P<0.001; relative reduction: -38%) and the National Nosocomial Infections Surveillance system (NNIS)-0 adjusted SSI incidence from 1.10% to 0.74% (P<0.001; relative reduction: -33%). The most significant SSI incidence reduction was observed for hernia repair and caesarean section, and to a lesser extent, cholecystectomy, hip prosthesis arthroplasty, and mastectomy. Active surveillance striving for a benchmark throughout a network is an effective strategy to reduce SSI incidence.

Comparison of the National Surgical Site Infection surveillance data between The Netherlands and Germany: PREZIES versus KISS

As there has been increasing interest in comparing surgical site infection (SSI) rates between countries, we compared the SSI surveillance data for The Netherlands ('PREZIES') and Germany ('KISS'). Both surveillance systems have comparable protocols with many similar risk factors, including SSI definitions developed by the Centers for Disease Control and Prevention and optional postdischarge surveillance. Nine surgical procedure categories from several specialities were included, the reporting of which were similar, with respect to content and with enough data for proper comparison. Differences for the SSI data were found between PREZIES and KISS for duration of surgery, wound contamination class, American Society of Anesthesiologists physical status classification and the postoperative duration of hospitalization. A significantly higher superficial SSI rate was found for seven surgical procedures according to PREZIES and a higher deep SSI rate for five procedures. When considering only deep SSI during hospitalization, the differences in SSI rates were much smaller. Differences in intensity of postdischarge surveillance led to 34% of SSI being detected after discharge for PREZIES and 21% for KISS. In conclusion, even though similar infection surveillance protocols are used in The Netherlands and Germany, differences occurred in the implementation. Comparisons between countries are most reliable if only deep SSIs during hospitalization are taken into account, since these SSI are not affected by postdischarge surveillance and the diagnostic sensitivity for deep SSI is probably more alike between countries than for superficial SSI.

First Results of National Surgical Site Infection Surveillance in Hungary

Healthcare-associated infections (HAI) are an important cause of morbidity and mortality, prolongs hospital stay, increases antibiotic usage, add costs.1 The surveillance of HAI has been acknowledged as an important component of infection control programmes, and is increasingly recognised as key to improving clinical outcomes.2Hungarian National Nosocomial Surveillance System (HNNSS) was established in 2004. The aim of this system has been to create a national database of HAI, to enable hospitals to perform surveillance of HAI and compare their results with national aggregated data and use the information to improve patient care.3 HNNSS is a standardized, secure web-based reporting system. It has 2 components: a mandatory and a voluntary part. Software is offered free for hospitals. Mandatory components are reports of nosocomial outbreaks, infections caused by multidrug resistant organisms and nosocomial bloodstream infections. Participation of hospitals in surveilance component is voluntary and confidential. Surveillance compontents are: intensive care unit (ICU) and surgical site infections (SSI). All data are received and analysed by National Center for Epidemiology. Reports of surveillance data are elaborated every six months. SSI surveillance started in November 2004. Hospitals can choose one or more of 36 defined categories (CDC-NNIS). With SSI surveillance component we joined European Surveillance network HELICS (Hospitals in Europe Link for Infection Controlthrough Surveillance).

FP3.04 Comparison of National Surgical Site Infection Surveillance Data between the Netherlands and Germany: Prezies Versus Kiss

FP3.04 Comparison of National Surgical Site Infection Surveillance Data between the Netherlands and Germany: Prezies Versus Kiss

P17.34 Results from the Scottish National Surgical Site Infection Surveillance Programme (SSHAIP)

P17.34 Results from the Scottish National Surgical Site Infection Surveillance Programme (SSHAIP)

Dutch reference data on the incidence of surgical site infection

Abstract Background The PREZIES national surveillance network supports Dutch hospitals in introducing surveillance of surgical site infection (SSI), generates reference data on the incidence of SSI and associated risk factors, and provides an infrastructure for interventional research. Its ultimate goal is to reduce the occurrence of SSI. The aim was to discuss the methods and results of the national SSI surveillance. Methods The participating institutions developed a surveillance protocol and an agreement on participation and privacy aspects. For each patient under surveillance, infection control practitioners collected data on the type of procedure, the occurrence of a superficial and/or deep SSI, and on several risk factors, i.e. age, American Society of Anesthesiologists score, wound contamination class, duration of surgery, preoperative length of stay, use of antibiotic prophylaxis, multiple surgery and elective/emergency surgery. Hospitals received standardized feedback reports comparing their own SSI rates with the national reference. Validation and use of surveillance data were studied within subsets of hospitals. Results Since June 1996, 70 of 114 hospitals of all types and sizes participated. The Table shows the number of operations, the incidence of all SSIs, the use of prophylactic antibiotics and the number of participating hospitals for five commonly recorded procedures. Of 38 hospitals studied, 19 used surveillance results in education, 22 in policy and decision making, and 16 in initiating interventions. Five reported a reduction in SSI incidence. A prevalence survey of SSI showed high agreement (κ = 0·88) with the validating team. Conclusion The PREZIES network provides hospitals with good quality national reference data that are used to support their policy for prevention of SSI.