Roumbelaki Maria, Kritsotakis Evangelos I, Tsioutis Constantinos, Tzilepi Penelope, Gikas Achilleas
Laboratory of Clinical Bacteriology, Parasitology, Zoonosis and Geographical Medicine, University of Crete, Crete, Greece.
Am J Infect Control. 2008 Dec;36(10):732-8. doi: 10.1016/j.ajic.2007.11.009. Epub 2008 Oct 3.
In this first attempt to implement a standardized surveillance system of surgical site infections (SSI) in a Greek hospital, our objective was to identify areas for improvement by comparing main epidemiologic and microbiologic features of SSI with international data.
The National Nosocomial Infections Surveillance (NNIS) system protocols were employed to prospectively collect data for patients in 8 surgical wards who underwent surgery during a 9-month period. SSI rates were benchmarked with international data using standardized infection ratios. Risk factors were evaluated by multivariate logistic regression.
A total of 129 SSI was identified in 2420 operations (5.3%), of which 47.3% developed after discharge. SSI rates were higher for 2 of 20 operation categories compared with Spanish and Italian data and for 12 of 20 categories compared with NNIS data. Gram-positive microorganisms accounted for 52.1% of SSI isolates, and Enterococci were predominant. Alarming resistance patterns for Enterococcus faecium and Acinetobacter baumannii were recorded. Potentially modifiable risk factors for SSI included multiple procedures, extended duration of operation, and antibiotic prophylaxis. SSI was associated with prolongation of postoperative stay but not with mortality.
Comparisons of surveillance data in our hospital with international benchmarks provided useful information for infection control interventions to reduce the incidence of SSI.
在希腊一家医院首次尝试实施手术部位感染（SSI）标准化监测系统时，我们的目标是通过比较SSI的主要流行病学和微生物学特征与国际数据来确定改进领域。
采用国家医院感染监测（NNIS）系统方案，前瞻性收集8个外科病房在9个月期间接受手术患者的数据。使用标准化感染率将SSI发生率与国际数据进行对比。通过多因素逻辑回归评估危险因素。
在2420例手术中，共识别出129例SSI（5.3%），其中47.3%在出院后发生。与西班牙和意大利数据相比，20种手术类别中有2种的SSI发生率更高；与NNIS数据相比，20种类别中有12种更高。革兰氏阳性微生物占SSI分离株的52.1%，肠球菌最为常见。记录到粪肠球菌和鲍曼不动杆菌令人担忧的耐药模式。SSI潜在的可改变危险因素包括多次手术、手术时间延长和抗生素预防。SSI与术后住院时间延长有关，但与死亡率无关。
将我院的监测数据与国际基准进行比较，为感染控制干预措施提供了有用信息，以降低SSI的发生率。
