Preah Kossamak Hospital, 271 Sangkat Teuk Loak II Street, Khan Tuol Kok, Phnom Penh City, Cambodia.
Prupet NGO, Centre Hospitalier Moulins, 10, Avenue Général de Gaulle, 03006 Moulins Cedex, France.
J Infect Public Health. 2015 May-Jun;8(3):298-301. doi: 10.1016/j.jiph.2014.09.007. Epub 2014 Nov 10.
Barriers to the implementation of the Centers for Disease Control and Prevention (CDC) guidelines for surgical site infection (SSI) surveillance have been described in resource-limited settings. This study aimed to estimate the SSI incidence rate in a Cambodian hospital and to compare different modalities of SSI surveillance. We performed an active prospective study with post-discharge surveillance. During the hospital stay, trained surveyors collected the CDC criteria to identify SSI by direct examination of the surgical site. After discharge, a card was given to each included patient to be presented to all practitioners examining the surgical site. Among 167 patients, direct examination of the surgical site identified a cumulative incidence rate of 14 infections per 100 patients. An independent review of medical charts presented a sensitivity of 16%. The sensitivity of the purulent drainage criterion to detect SSIs was 83%. After hospital discharge, 87% of the patients provided follow-up data, and nine purulent drainages were reported by a practitioner (cumulative incidence rate: 20%). Overall, the incidence rate was dependent on the surveillance modalities. The review of medical charts to identify SSIs during hospitalization was not effective; the use of a follow-up card with phone calls for post-discharge surveillance was effective.
在资源有限的环境中，已经描述了实施疾病预防控制中心（CDC）手术部位感染（SSI）监测指南的障碍。本研究旨在估计柬埔寨一家医院的 SSI 发生率，并比较不同的 SSI 监测方式。我们进行了一项主动前瞻性研究，采用出院后监测。在住院期间，受过培训的调查员收集了 CDC 标准，通过直接检查手术部位来确定 SSI。出院后，为每位纳入的患者发放一张卡片，以便所有检查手术部位的医生使用。在 167 名患者中，直接检查手术部位发现 100 名患者中有 14 例感染的累积发生率。对病历的独立审查显示敏感性为 16%。脓性引流的标准对 SSI 的敏感性为 83%。出院后，87%的患者提供了随访数据，有一名医生报告了 9 例脓性引流（累积发生率：20%）。总体而言，发生率取决于监测方式。住院期间通过审查病历来识别 SSI 的方法效果不佳；使用带有出院后随访电话的随访卡进行监测是有效的。
