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Repeated prevalence surveys of surgical site infections in a Turkish university hospital

Abstract number: 1734_163

Yildiz O., Alp E., Yucel S., Kiran B., Tucer B., Ok E., Aygen B.

Objectives: The aim of this study was to clarify factors influencing the prevalence of surgical site infections (SSI) undergoing general surgery and neurosurgery, as well as to determine the effectiveness of infection control measures for SSI.

Methods: Two prevalence surveys were carried out during the first six months of 2005 and 2006, after implementing infection control measures in an 1136-bedded teaching hospital. A total of 3924 surgical patients (2263 in general surgery and 1661 in neurosurgery wards) were investigated, the number of patients in the two studies were 2026 in 2005 and 1898 in 2006. The patients were assessed for SSI by review of medical records and by discussion with ward nursing and medical staff. The changes in infection control activities during the 18-month period included educational programmes to healthcare workers, increasing the number of infection control nurses, implementing published guidelines on prevention and control of hospital associated infections, postoperative incision and intravascular catheter care.

Results: During the period of observation, 5.5% of 3924 patients had SSI, 16 (0.4%) had superficial incisional SSI, 117 (3%) had deep incisional SSI and 81 (2.1%) had organ space SSI. The infection rate was 4.4% for clean and clean-contaminated surgery, 14.8% for contaminated and dirty surgery; 4.1% for American Society of Anaesthesiologists (ASA) score I, 5.7% for ASA score II, 9.7% for ASA score III, 9.8% for ASA score IV and 33.3% for ASA score V. The prevalence of SSI decreased significantly from 6.5% in 2005 to 4.4% in 2006 (p = 0.005). In general surgical patients, the SSI rate in 2006 was significantly lower than that of 2005 (5.1% and 7.6%, respectively, p = 0.017). During the same period, the SSI rates were not significantly different for neurosurgical patients (3.4% in 2006 and 4.9% in 2005, p = 0.151).

Conclusion: The risk factors for SSI were higher degree of wound contamination, poor physical status according to ASA classification, prolonged duration and type of operation, inappropriate use of antibiotics for surgical prophylaxis and use of surgical drains.

Implementation of infection control policies can have a significant impact on the prevalence of SSI, and their effectiveness could be measured by repeated prevalence surveys.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Subject:
Location: ICC, Munich, Germany
Presentation type:
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