Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Infect Control Hosp Epidemiol. 2012 Jun;33(6):572-80. doi: 10.1086/665728. Epub 2012 Apr 19.
To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.
A nationwide prospective multicenter study.
Twenty university-affiliated hospitals in Korea.
The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.
Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (± SD) was 58.8 (± 12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09-2.58]), increased operation time (1.20 [1.07-1.34] per 1-hour increase), reoperation (7.27 [3.68-14.38]), combined multiple procedures (1.79 [1.13-2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09-8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26-5.64]) were independently associated with increased risk of SSI.
Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.
评估韩国胃手术后手术部位感染（SSI）的危险因素。
全国前瞻性多中心研究。
韩国 20 所大学附属医院。
开发了韩国医院感染监测系统（KONIS），这是一个基于网络的系统。2007 年至 2009 年，韩国 20 家医院的患者在胃手术后 30 天内接受了前瞻性监测，以确定 SSI。收集并分析了人口统计学数据、医院特征和潜在围手术期危险因素，使用多变量逻辑回归模型进行分析。
在监测的 4238 例病例中，64.9%（2752 例）为男性，平均年龄（±标准差）为 58.8（±12.3）岁。国家医院感染监测系统风险指数类别为 0、1 和 2 或 3 的患者中，SSI 发生率分别为每 100 例手术 2.92、6.45 和 10.87 例。观察到的大多数 SSI 为器官或空间 SSI。最常分离的微生物是金黄色葡萄球菌和肺炎克雷伯菌。男性（比值比[OR]，1.67[95%置信区间（CI），1.09-2.58]）、手术时间延长（每增加 1 小时增加 1.20[1.07-1.34]）、再次手术（7.27[3.68-14.38]）、联合多个程序（1.79[1.13-2.83]）、切口皮肤后首次预防性使用抗生素（3.00[1.09-8.23]）和手术抗生素预防持续时间延长（≥7 天）（2.70[1.26-5.64]）与 SSI 风险增加独立相关。
男性、不适当的 SAP 和与手术相关的变量是胃手术后 SSI 的独立危险因素。
