Spolaore P, Pellizzer G, Fedeli U, Schievano E, Mantoan P, Timillero L, Saia M
Epidemiological Department, Veneto Region, SER, Via Ospedale, 18-31033 Castelfranco Veneto (TV), Italy.
J Hosp Infect. 2005 Aug;60(4):317-20. doi: 10.1016/j.jhin.2005.01.005.
Surveillance of surgical site infections (SSIs) with feedback to surgical personnel is pivotal in decisions regarding infection control. Prospective surveillance is time and resource consuming, so we aimed to evaluate a method based on data collected routinely during care delivery. The study was carried out at three acute hospitals in North-eastern Italy, from 1 January 2001 to 31 December 2001. Hospital discharge diagnoses (selected codes from the International Classification of Diseases, 9th Revision--Clinical Modification) and electronic microbiology reports (positive cultures from surgical wounds and drainages) were linked to identify suspected SSIs. A random sample of tracked events was submitted to total chart review in order to confirm the presence of SSIs retrospectively according to Centers for Disease Control and Prevention definitions. Of 865 suspected SSIs, 64.5% were identified from the microbiological database, 27.1% from discharge codes, and 8.4% from both. Four hundred and three admissions were sampled for review; the overall positive predictive value was 72% (95%CI=69-76%). Since inpatient individual antibiotic exposure is not registered in Italy, the combined use of discharge codes and microbiology reports represents the most feasible automated method for surveillance of SSIs developing during hospital stay.
对手术部位感染（SSIs）进行监测并向手术人员反馈，这对感染控制决策至关重要。前瞻性监测耗费时间和资源，因此我们旨在评估一种基于护理过程中常规收集数据的方法。该研究于2001年1月1日至2001年12月31日在意大利东北部的三家急症医院开展。将医院出院诊断（从《国际疾病分类》第9版——临床修订版中选取的编码）与电子微生物学报告（手术伤口和引流液的阳性培养结果）相关联，以识别疑似手术部位感染。对追踪到的事件进行随机抽样，以便根据疾病控制与预防中心的定义进行回顾性全病历审查，确认手术部位感染的存在。在865例疑似手术部位感染中，64.5%通过微生物数据库识别，27.1%通过出院编码识别，8.4%通过两者共同识别。抽取了403例入院病例进行审查；总体阳性预测值为72%（95%CI = 69 - 76%）。由于意大利未记录住院患者个体的抗生素暴露情况，因此结合使用出院编码和微生物学报告是监测住院期间发生的手术部位感染最可行的自动化方法。
