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Dhamnaskar S, Mandal S, Koranne M, Patil P. Preoperative Surgical Site Hair Removal for Elective Abdominal Surgery: Does It Have Impact on Surgical Site Infection. Surg J (N Y) 2022; 8:e179-e186. [PMID: 35928549 PMCID: PMC9345678 DOI: 10.1055/s-0042-1749425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/08/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction
Postoperative surgical site infection (SSI) forms the major burden of nosocomial infections in surgical patients. There is prevalent practice of surgical site hair shaving as a part of preoperative preparation. There is uncertainty regarding the benefit versus harm of shaving for SSIs. Hairs at surgical sites are removed prior to surgery most often by shaving. We performed this study to look for what impact preoperative hair removal by shaving has on postoperative SSI.
Methods
We performed prospective comparative cohort study in patients undergoing elective abdominal surgeries. We included clean and clean-contaminated surgeries in immunocompetent patients of which half were shaved and other half not shaved prior to surgery. Other confounding factors like skin cleaning, aseptic technique of surgery, antibiotic prophylaxis and treatment, and postoperative wound care were as per care. Patients were assessed for presence and grade of SSI postoperatively on day 7, 14, and 30. Results were analyzed statistically using chi-square and Fischer's exact tests for significance in entire sample as well as in demographic subgroups.
Results
Overall SSI rate was 11.42%. There was no statistically significant difference in SSI rates between patients who underwent preoperative surgical site hair removal by shaving (232) and who did not have shaving (232) on all the three different assessment timelines in postoperative period, namely, day 7, 14, and 30. Although the absolute number of patients who had SSI was more in those who underwent preoperative surgical site hair removal by shaving, the difference was not statistically significant (
p
> 0.05). But on subgroup analysis patients with clean-contaminated surgeries (
p
= 0.037) and patients with surgeries lasting for less than 2 hours (Fischer's exact = 0.034) had significantly higher SSI in the shaved group compared with unshaved on day 14.
Conclusion
As per our results, preoperative shaving did not significantly increase overall SSI except in subgroup of clean-contaminated surgeries and in surgeries of less than 2 hours' duration. So especially in these patients avoiding preoperative surgical site hair shaving may be used as one of the infection control measures.
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Affiliation(s)
- Suchin Dhamnaskar
- Seth G.S. Medical College, King Edward memorial hospital, Mumbai, India
| | - Sumit Mandal
- Seth G.S. Medical College, King Edward memorial hospital, Mumbai, India
| | - Mandar Koranne
- Seth G.S. Medical College, King Edward memorial hospital, Mumbai, India
| | - Pratik Patil
- Seth G.S. Medical College, King Edward memorial hospital, Mumbai, India
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Quality improvement in hospitals in the Russian Federation, 2000-2016: a systematic review. HEALTH ECONOMICS POLICY AND LAW 2019; 15:403-413. [PMID: 31581966 PMCID: PMC7525099 DOI: 10.1017/s1744133119000252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We reviewed published evidence on quality improvement in hospitals in the Russian Federation since 2000. We used three data sources: MEDLINE, 'Rossiiskaia Meditsina' (Central Scientific Medical Library), and elibrary.ru using specific search terms. No language or study design restrictions were imposed. In total, 1717 articles were identified; 51 met the inclusion criteria and were thematically analysed. Russian legislation, government acts and grey literature were sourced to contextualise identified themes. Since 2010, the Federal Ministry of Health has increasingly sought to improve quality of care, providing additional resources and new initiatives across the health system. These include clinical practice guidelines, pay for performance schemes, electronic medical records, more specialist care, paraclinical care, and quality control systems. Quality of care, increasingly a concern of the Russian government, is said to be improving. Yet most initiatives have rarely been evaluated. This reflects the limited capacity for health services research in Russia. It seems likely that the full potential for improvements in quality of care in Russia is still to be realised.
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Olowo-Okere A, Ibrahim YKE, Olayinka BO, Ehinmidu JO. Epidemiology of surgical site infections in Nigeria: A systematic review and meta-analysis. Niger Postgrad Med J 2019; 26:143-151. [PMID: 31441451 DOI: 10.4103/npmj.npmj_72_19] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Surgical site infection (SSI) is a major patient safety concern in hospitals. Unlike most developed countries, Nigeria does not yet have an established national system to monitor the occurrence of this infection. This meta-analysis was thus designed to determine the pooled cumulative incidence of SSIs and various determinants of its occurrence in Nigeria. Methods The electronic databases were systematically searched for articles reporting the occurrence and risk factors associated with SSIs in Nigeria from January 2000 to December 2018. The eligible articles were evaluated using a set of pre-defined criteria. The extracted data were analysed using the comprehensive meta-analysis software. The Begg and Egger's regression tests were used to assess the risk of bias of the included publications. Results Thirty-two articles emanating from the six geopolitical regions of Nigeria were included in this meta-analysis. The pooled cumulative incidence of SSIs was 14.5% (95% confidence interval [CI]: 0.113-0.184) with the highest incidence reported in the north-eastern region (27.3%, 95% CI: 0.132-0.481) of the country. It was also found to occur more predominantly following colorectal and abdominal surgeries, among elderly patients and in patients with co-morbid conditions. The most frequently reported was the superficial incisional SSIs occurring in 62.5% (95% CI: 0.333-0.848). Higher preponderance was also observed among patients with dirty wounds (52.7%, 95% CI: 0.367-0.682). Conclusion This meta-analysis documents for the first time the national burden of SSIs in Nigeria. Control measures geared towards its reduction should be strengthened and a national policy on SSI surveillance, prevention and control developed.
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Affiliation(s)
- Ahmed Olowo-Okere
- Department of Pharmaceutics and Pharmaceutical Microbiology, Usmanu Danfodiyo University, Sokoto, Nigeria
| | | | - Busayo Olalekan Olayinka
- Department of Pharmaceutics and Pharmaceutical Microbiology, Ahmadu Bello University, Zaria, Nigeria
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The prevalence and root causes of surgical site infections in public versus private hospitals in Ethiopia: a retrospective observational cohort study. Patient Saf Surg 2019; 13:26. [PMID: 31333761 PMCID: PMC6617908 DOI: 10.1186/s13037-019-0206-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/02/2019] [Indexed: 12/14/2022] Open
Abstract
Background Healthcare-associated illnesses, of which surgical site infection is the most common are significant causes of morbidity and mortality. Therefore, this study aimed to determine the prevalence and root causes of surgical site infections in public versus private hospitals in Ethiopia. Methods An institution based retrospective observational cohort study was conducted among patients who underwent surgical procedures at public and private health facilities from March 15 to April 15, 2018. Samples were selected by the simple random sampling technique, and data extracted from the patient’s medical chart, operation, and anesthesia notes. Data were entered using Epi info version 7 and analyzed using STATA 14. Binary logistic regression was fitted to identify factors associated with surgical site infections in private and public hospitals. Crude and adjusted odds ratios (OR) with a 95% confidence interval (CI) were computed to assess the strength of associations. Variables with a p-value less than 0.05 in the multivariable logistic regression model considered as significant predictors of surgical site infections. Result The overall prevalence of surgical site infections was 9.9% (95%CI: 7.8, 12.5). The prevalence of the infections was higher in procedures performed in public hospitals (13.4%) compared to private hospitals (6.5%). Rural residence (AOR = 0.13, 95%CI: 0.034 0.55), clean-contaminated and dirty wound (AOR = 12.81, 95%CI: 4.42 37.08) were significant predictors of the infections in private hospitals. Similarly, clean-contaminated and dirty wounds (AOR = 4.37, 95%CI: 1.88 10.14), length of hospital stay≥6 days (AOR = 2.86, 95%CI: 1.11 7.33), and surgical operation time of over 1 h (AOR = 15.24, 95%CI: 4.48 51.83) were such factors in public hospitals. Conclusion The prevalence of surgical site infections was high, and significant differences were also observed between public and private hospitals. Clean-contaminated and dirty wounds, prolonged operation, and length of hospital stay were predictors of surgical site infections among patients in public hospitals, whereas clean-contaminated wound and rural dwellings were predicted the infections among patients operated in the private hospital.
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Can surgical site infections be controlled through microbiological surveillance? A three-year laboratory-based surveillance at an orthopaedic unit, retrospective observatory study. INTERNATIONAL ORTHOPAEDICS 2019; 43:2009-2016. [PMID: 30680519 PMCID: PMC6698262 DOI: 10.1007/s00264-019-04298-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 01/08/2019] [Indexed: 11/01/2022]
Abstract
OBJECTIVE The aims of the study were to analyse the surgical site infections (SSIs) in patients operated at an orthopaedic ward and to describe the drug-resistance of the aetiology of those infections. Also, analyse the possibility of SSI control through microbiological surveillance. Additionally, we have studied the information inferred by aggregating cumulative antibiograms for the SSIs of the studied orthopaedic unit. DESIGN Cross-sectional studies carried out in 2013-2015. SETTING AND PATIENTS Orthopaedic and Trauma Surgery Unit in Sosnowiec, Poland; 5995 patients, 5239 operations. METHODS Retrospective laboratory-based data collection study of surgical site infections. RESULTS SSI incidence rate was 6.6%, in the implantations-hip prosthesis 5.8% and knee prosthesis 5.4%, about 6 times higher compared with European HAI-Net. SSIs were usually caused by Gram-positive bacteria (56%). The prevalence of MDR microorganisms was 22.6%, and mainly concerned the Gram-negative bacilli: 97.6% of Acinetobacter baumannii and 50.0% of Klebsiella pneumoniae were multidrug-resistant. On the basis of what the Formula for Rational Empiric Antimicrobial Therapy analysis has shown, the use of amikacin, imipenem and ciprofloxacin has been recommended as the most efficient in the empirical therapy of SSIs. CONCLUSIONS The infection control was a significant problem at the studied orthopaedic unit, as evidenced by the SSI incidence rate significantly higher than expected. We suggest implementing the infection control and prevention based on evidence-based medicine, and a unit-based surveillance. A cumulative unit-based antibiogram reflects the drug-susceptibility pattern for the strains from the infections acquired at the unit.
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Dimopoulou A, Papanikolaou Z, Kourlaba G, Kopsidas I, Coffin S, Zaoutis T. Surgical Site Infections and Compliance with Perioperative Antimicrobial Prophylaxis in Greek Children. Infect Control Hosp Epidemiol 2016; 35:1425-7. [DOI: 10.1086/678411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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The incidence and distribution of surgical site infection in mainland China: a meta-analysis of 84 prospective observational studies. Sci Rep 2014; 4:6783. [PMID: 25356832 PMCID: PMC4214160 DOI: 10.1038/srep06783] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Accepted: 10/01/2014] [Indexed: 02/02/2023] Open
Abstract
Surgical site infection (SSI) is one of the most common surgical complications in the world, particularly in developing countries. This study aimed to estimate the incidence and distribution of SSI in mainland China. Eighty-four prospective observational studies (82 surveillance studies, 1 nested case control study, and 1 cohort study) were selected for inclusion in this meta-analysis. The average incidence of SSI in mainland China was 4.5% (95% CI: 3.1–5.8) from 2001 to 2012 and has decreased significantly in recent years. The remote western regions had a higher incidence of 4.6% (95% CI: 4.0–5.3). The most common surgical procedure was abdominal surgery (8.3%, 95% CI: 6.5–10.0). SSI occurred frequently in the elderly (5.1%, 95% CI: 2.2–8.0), patients confined to hospital for over 2 weeks (5.7%, 95% CI: 0.9–10.0), superficial incision wounds (5.6%, 95% CI: 4.4–6.8), dirty wounds (8.7%, 95% CI: 6.9–10.6), operations lasting for over 2 hours (7.3%, 95% CI: 4.9–9.7), general anaesthesia operations (4.7%, 95% CI: 2.7–6.6), emergency surgeries (5.9%, 95% CI: 4.2–7.7), and non-intra-medication operations (7.4%, 95% CI: 1.0–13.7).
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Gharde P, Swarnkar M, Waghmare LS, Bhagat VM, Gode DS, Wagh DD, Muntode P, Rohariya H, Sharma A. Role of antibiotics on surgical site infection in cases of open and laparoscopic cholecystectomy: a comparative observational study. J Surg Tech Case Rep 2014; 6:1-4. [PMID: 25013542 PMCID: PMC4090972 DOI: 10.4103/2006-8808.135132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Surgical site infection (SSI) comes as third most common healthcare related infection which produces morbidity and deaths at large. Still many authors believe that it is better not to use prophylactic antibiotics in simple and uncomplicated cases. Laparoscope, now-a-days is a much used instrument for abdominal surgeries. Even after new aseptic techniques SSI remains to be a major problem. AIMS AND OBJECTIVES To study the effect of antibiotics on superficial SSI in the cases of open and laparoscopic cholecystectomy. OBSERVATION AND RESULTS One hundred patients were enrolled for cholecystectomy. The patients were divided into two groups, A and B. Group A consisted of patients in whom laparoscopic cholecystectomy was done and group B in whom open cholecystectomy was done. The male female ratio was 1: 2.23. The mean age of patients in Group A was 46 years and in Group B was 44; Standard deviation (SD) for age was 14.8% and 13.8% in groups A and B respectively; t-value was 0.654 and P value was 0.515 and they were not significant. The number of males and females was 16 and 26 respectively in Group A and 11 and 31 in Group B. The Chi square X(2) = 1.36 and P value was 0.248 and both were insignificant. The rate of superficial surgical site infection was 2.63% in both the groups. CONCLUSION Our study concludes that there is no difference in the outcome of patients in cases of open as well as laparoscopic cholecystectomy. There is no significant difference in the surgical site infection rate in cases of open as well as laparoscopic cholecystectomy.
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Affiliation(s)
- Pankaj Gharde
- Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| | - Manish Swarnkar
- Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| | - Lalitbhushan S Waghmare
- Department of Physiology and Dean Interdisciplinary Sciences, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| | - Vijay Manohar Bhagat
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| | - Dilip S Gode
- Honourable Vice Chancellor and laparoscopic surgeon, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| | - Dhirendra D Wagh
- Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| | - Pramita Muntode
- Department of Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| | - Hrituraj Rohariya
- Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
| | - Anoop Sharma
- Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (DU), Wardha, Maharashtra, India
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Preliminary data of the Surveillance of Surgical Site infections at Gaziantep University Hospital. J Infect Public Health 2013; 6:289-95. [DOI: 10.1016/j.jiph.2012.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Revised: 12/09/2012] [Accepted: 12/28/2012] [Indexed: 01/31/2023] Open
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Post-discharge surveillance of wound infections by telephone calls method in a Sudanese Teaching Hospital. J Infect Public Health 2013; 6:339-46. [PMID: 23999331 DOI: 10.1016/j.jiph.2013.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 04/04/2013] [Accepted: 04/05/2013] [Indexed: 12/31/2022] Open
Abstract
UNLABELLED Surveillance of wound infections has been shown to be a powerful preventive tool, and feedback to the clinical staff reduces wound infection rates. The main objectives of this study were to identify the applicability of telephone calls as a method of post-discharge wound infection surveillance, and to identify patients and procedures characteristics associated with loss for follow-up after hospital discharge. MATERIALS AND METHODS This was a prospective cohort study conducted in Khartoum Teaching Hospital, Sudan. Patients, aged >18 years admitted for elective clean and clean-contaminated surgery during March 1st to 31st October 2010 were recruited. 1-month surveillance of wound infections was conducted with telephone interviews. RESULTS Overall 3656 patients were operated on. Of them 1769 (48.4%) were eligible {mean age 37.8+14 years; females, n=1472 (83.3%)}. The performed surgical interventions were 1814. Of these 1277 (70.4%) were clean-contaminated and 537 (29.6%) were clean. Patients who successfully completed the follow-up were 1387 (78.4%), while 368 (20.8%) were lost, and 14 (0.8%) died. The percentage of male patients (85.3%) who successfully completed the follow-up was significantly higher than females (77.8%); (P=0.002). Wound infection was detected in 15 (0.8%) cases during hospital stay and 110 (6.2%) others after hospital discharge. CONCLUSIONS The majority of wound infections in the current study appeared in post-discharge period; this emphasis the need for establishment of surveillance program in the hospital. Surveillance of wound infections using telephone calls is applicable in this setting and can be used as an alternative method to clinic-based diagnosis of wound infections.
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Ider BE, Adams J, Morton A, Whitby M, Clements A. Infection control systems in transition: the challenges for post-Soviet Bloc countries. J Hosp Infect 2012; 80:277-87. [PMID: 22377387 DOI: 10.1016/j.jhin.2012.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 01/24/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Just two decades ago, 30 of today's countries in Europe and Asia had socialist governments under Soviet dominance or direct administration. Intensive health system reforms have altered infection control in many of these countries. However, much of the literature from these countries is difficult to access by international scientists. AIM To summarize existing infection control policies and practices in post-Soviet Bloc countries. METHODS In addition to PubMed and Google search engines, we explored local websites and grey literature. In total, 192 references published in several languages were reviewed. FINDINGS Infection control in these countries is in the midst of transition. Three groups of countries were identified. First, Eastern European and Baltic countries building surveillance systems for specific pathogens and antibiotic use; second, European post-Soviet Bloc countries focusing on the harmonization of recently established infection control infrastructure with European surveillance programmes; third, countries such as those formerly in the Union of Soviet Socialist Republics, Mongolia and post-conflict Eastern European countries that are in the first stages of reform. Poor commitment, resource scarcity and shortages of expertise were identified. Underreporting of official infection control statistics is widespread. CONCLUSIONS Guidance from international organizations has been crucial in initiating and developing contemporary infection control programmes. More support from the international community will be needed for the third group of countries, where infection control has remained a neglected issue.
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Affiliation(s)
- B-E Ider
- University of Queensland, School of Population Health, Brisbane, Queensland, Australia.
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Allegranzi B, Bagheri Nejad S, Combescure C, Graafmans W, Attar H, Donaldson L, Pittet D. Burden of endemic health-care-associated infection in developing countries: systematic review and meta-analysis. Lancet 2011; 377:228-41. [PMID: 21146207 DOI: 10.1016/s0140-6736(10)61458-4] [Citation(s) in RCA: 1290] [Impact Index Per Article: 99.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Health-care-associated infection is the most frequent result of unsafe patient care worldwide, but few data are available from the developing world. We aimed to assess the epidemiology of endemic health-care-associated infection in developing countries. METHODS We searched electronic databases and reference lists of relevant papers for articles published 1995-2008. Studies containing full or partial data from developing countries related to infection prevalence or incidence-including overall health-care-associated infection and major infection sites, and their microbiological cause-were selected. We classified studies as low-quality or high-quality according to predefined criteria. Data were pooled for analysis. FINDINGS Of 271 selected articles, 220 were included in the final analysis. Limited data were retrieved from some regions and many countries were not represented. 118 (54%) studies were low quality. In general, infection frequencies reported in high-quality studies were greater than those from low-quality studies. Prevalence of health-care-associated infection (pooled prevalence in high-quality studies, 15·5 per 100 patients [95% CI 12·6-18·9]) was much higher than proportions reported from Europe and the USA. Pooled overall health-care-associated infection density in adult intensive-care units was 47·9 per 1000 patient-days (95% CI 36·7-59·1), at least three times as high as densities reported from the USA. Surgical-site infection was the leading infection in hospitals (pooled cumulative incidence 5·6 per 100 surgical procedures), strikingly higher than proportions recorded in developed countries. Gram-negative bacilli represented the most common nosocomial isolates. Apart from meticillin resistance, noted in 158 of 290 (54%) Staphylococcus aureus isolates (in eight studies), very few articles reported antimicrobial resistance. INTERPRETATION The burden of health-care-associated infection in developing countries is high. Our findings indicate a need to improve surveillance and infection-control practices. FUNDING World Health Organization.
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Varik K, Kirsimägi Ü, Värimäe EA, Eller M, Lõivukene R, Kübarsepp V. Incidence and Risk Factors of Surgical Wound Infection in Children: A Prospective Study. Scand J Surg 2010; 99:162-6. [DOI: 10.1177/145749691009900311] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background and Aims: To establish the incidence and risk factors of surgical site infection (SSI) in children operated in the Department of Paediatric Surgery of the Clinic of Surgery of Tartu University Hospital. Material and Methods: The data of wound healing were obtained for 589 children operated between 15 March 2003 and 31 March 2005. The operations were divided into general surgical (451), orthopaedic (70) and urological (68). The surgical wounds were classified as clean (442), clean-contaminated (96), contaminated (36) and dirty-infected (15). Univariate and multivariate analyses were performed to identify risk factors. Results: There were 7 SSI cases, overall rate being 1.2%. Superficial wound infection occurred in 5 cases and deep wound infection occurred in 2 cases. There was no organ/space infection. SSI was significantly more frequent in the case of contaminated and dirty-infected compared with clean or clean—contaminated operations, 7.8% and 0.6%, respectively (p = 0.0008). Wound infection endangered more children who had operation related complications compared with non-complicated cases, 11.1% and 0.4%, respectively (p < 0.0001).
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Affiliation(s)
- K. Varik
- Tartu University Department of Surgery, Tartu, Estonia
| | - Ü. Kirsimägi
- Tartu University Department of Surgery, Tartu, Estonia
| | - E.-A. Värimäe
- Tartu University Department of Surgery, Tartu, Estonia
| | - M. Eller
- Tartu University Department of Surgery, Tartu, Estonia
| | - R. Lõivukene
- Tartu University Department of Surgery, Tartu, Estonia
| | - V. Kübarsepp
- Tartu University Department of Surgery, Tartu, Estonia
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Brown S, Kurtsikashvili G, Alonso-Echanove J, Ghadua M, Ahmeteli L, Bochoidze T, Shushtakashvili M, Eremin S, Tsertsvadze E, Imnadze P, O'Rourke E. Prevalence and predictors of surgical site infection in Tbilisi, Republic of Georgia. J Hosp Infect 2007; 66:160-6. [PMID: 17513010 DOI: 10.1016/j.jhin.2007.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Accepted: 03/07/2007] [Indexed: 10/23/2022]
Abstract
Surgical site infections (SSIs) are a serious problem worldwide. Little is known about the epidemiology of SSI in the former Soviet Union. In order to determine the prevalence and predictors of SSI in the Republic of Georgia, we undertook a multicentre observational study of SSIs in three urban hospitals in the capital, Tbilisi. Point prevalence studies (PPS) were performed every 3-5 weeks from September 2000 to January 2002 using the National Nosocomial Infections Surveillance (NNIS) System definitions. All patients who had undergone surgery and were present in participating departments at study hospitals on the day of PPS were included. Of 872 surgical procedures, 146 (16.7%) were complicated by SSI. The prevalence of SSI varied by procedure and risk category. On multivariate regression analysis, age, wound class, one hospital (B) and urological surgery were predictive of SSI. In a separate model, NNIS risk index was highly predictive of SSI. Antibiotic prophylaxis was rare (29.5% of operations), while postoperative antibiotic use was common. SSI is an important problem in the Republic of Georgia. Potential areas for intervention include antibiotic prophylaxis and shaving practices for skin preparation.
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Affiliation(s)
- S Brown
- Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA.
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