Abstract:
BACKGROUND:The prevalence of surgical site infections (SSI) is second only to urinary tract infections in hospitalized patients. They continue to threaten the health of hospitalized patients and impact negatively on the financial solvency of hospitals through prolonged hospitalization, increased rates of rehospitalization, and significantly increased health care costs. METHODS:We describe the effect of a 12-year surveillance program that included postdischarge follow-up and feedback to clinicians on the rate of SSI and the effect when surveillance is interrupted. Surgical procedures performed at the Royal Hobart Hospital (RHH), a university teaching hospital in Australia, between 1988 and 2001 were monitored for evidence of SSI in hospitals and for up to 30 days postoperatively. The surveillance program was inadvertently disrupted for 15 months from October 1990 to January 1992 and then recommenced. It has been ongoing since that time, apart from a 3-month interruption in 1998. Infection rates were determined on a regular basis, and these results were provided to surgeons, theatre staff, and surgical ward staff every 6 months. Patients included all adult surgical patients with an incisional wound, excluding burn patients and day-only surgical patients. RESULTS:Over the 12-year active surveillance period, 47,581 surgical procedures were followed for SSI. In-hospital SSI rates declined significantly over the study period from 4.7% (95% CI: 3.9%-5.6%) in 1988-1989 to 1.2% (95% CI: 0.8%-1.7%) in 2001 (P < .0001). Infection rates fell rapidly following the commencement of the program. This decline was halted during the period from October 1990 to January 1992 when the program was suspended. In-hospital SSI rates declined once again following the recommencement of the surveillance program, and these lower rates have been maintained. In contrast, postdischarge infection rates rose significantly from 1.2% (95% CI: 0.8%-1.7%) in 1988-1989 to 2.1% (95% CI: 1.6%-2.7%) in 2001 (P < .0001). CONCLUSION:The introduction of a program of continuous SSI surveillance at the RHH was associated with a reduction in the in-hospital and total SSI rate. This phenomenon was repeated following the recommencement of the program after a temporary interruption. Increasing numbers of SSIs are arising after hospital discharge. Many of these patients are readmitted to the hospital for further management of the SSI. Surveillance programs that do not perform postdischarge surveillance will have difficulty in capturing this data. Our experience supports the Study on the Efficacy of Nosocomial Infection Control (SENIC) findings, showing that health care facilities can achieve improved levels of infection management with active surveillance programs.
journal_name
Am J Infect Controljournal_title
American journal of infection controlauthors
Sykes PK,Brodribb RK,McLaws ML,McGregor Adoi
10.1016/j.ajic.2005.04.244subject
Has Abstractpub_date
2005-09-01 00:00:00pages
422-7issue
7eissn
0196-6553issn
1527-3296pii
S0196-6553(05)00429-3journal_volume
33pub_type
杂志文章abstract::Randomized controlled trials (RCTs) are useful in the evaluation of both new and well-established hospital infection control practices for which the benefit is unproven and not obvious. RCTs are often undertaken to resolve controversies, and many of them have a "negative" or inconclusive outcome. Well-designed RCTs wi...
journal_title:American journal of infection control
pub_type: 临床试验,杂志文章,评审
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更新日期:1983-10-01 00:00:00
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journal_title:American journal of infection control
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journal_title:American journal of infection control
pub_type: 杂志文章,实务指引
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journal_title:American journal of infection control
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journal_title:American journal of infection control
pub_type: 杂志文章,评审
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更新日期:1989-10-01 00:00:00
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journal_title:American journal of infection control
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journal_title:American journal of infection control
pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:American journal of infection control
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更新日期:2003-08-01 00:00:00
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journal_title:American journal of infection control
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更新日期:2002-10-01 00:00:00
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journal_title:American journal of infection control
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更新日期:2019-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2015-12-01 00:00:00
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journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2012.02.037
更新日期:2013-01-01 00:00:00
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journal_title:American journal of infection control
pub_type: 杂志文章,评审
doi:10.1016/j.ajic.2012.05.026
更新日期:2013-06-01 00:00:00
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journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/s0196-6553(98)70043-4
更新日期:1998-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:1995-12-01 00:00:00
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journal_title:American journal of infection control
pub_type: 临床试验,杂志文章
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更新日期:1993-08-01 00:00:00
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pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ajic.2017.11.032
更新日期:2018-07-01 00:00:00
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journal_title:American journal of infection control
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更新日期:2020-04-01 00:00:00
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journal_title:American journal of infection control
pub_type: 杂志文章
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更新日期:2014-03-01 00:00:00
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journal_title:American journal of infection control
pub_type: 杂志文章
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journal_title:American journal of infection control
pub_type: 杂志文章
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更新日期:2020-01-01 00:00:00
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journal_title:American journal of infection control
pub_type: 杂志文章
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更新日期:2021-02-01 00:00:00