Mintjes-de Groot A J, van den Berg J M, Veerman-Brenzikofer M L, de Boer A S, Smook A O
Centraal Begeleidingsorgaan voor de Intercollegiale Toetsing (CBO), Utrecht.
Ned Tijdschr Geneeskd. 1998 Jan 3;142(1):22-6.
To inventory postoperative infections in Dutch hospitals.
Descriptive study.
National organization for quality assurance in hospitals, Utrecht, the Netherlands.
In 36 Dutch hospitals data on surgical patients, surgical site infections and risk factors were collected, using standardised methods, as part of a quality system by which hospitals could compare their infection rates with the rates in the database.
Surveillance of surgical site infections was introduced in 36/118 (31%) hospitals. Data on 32,869 surgical procedures were collected, 1115 (3.4%) surgical site infections were found. The infection rates by wound contamination class varied from 2.2% (95% confidence interval (CI): 2.0-2.4) in clean wounds to 11% (95% CI: 9.3-12.8) in dirty wounds; the infection rates by duration of operation varied from 3% (95% CI: 2.8-3.2) in operations lasting less than two hours to 10.8% (95% CI: 6.0-18.5) in operations lasting more than 8 hours; the infection rate by ASA classification varied from 2.7% (95% CI: 2.3-3.2) in class I to 15.5% (95% CI: 8.4-26.5) in patients in class IV. Advanced age, emergency, preoperative stay were recognised as risk factors. The infection rates in the most frequently recorded types of operation varied from 0.2% (95% CI: 0.0-1.1) in varicose veins to 9.8% (95% CI: 7.2-13.2) in femoral bypass grafts. The use of antimicrobial prophylaxis varied per type of operation. The micro-organisms most frequently isolated were Staphylococcus aureus. Staphylococcus epidermidis, Pseudomonas aeruginosa, and Escherichia coli. Of the infections 32% were identified in the first week following surgery. Of the infected patients 88% stayed in hospital during one or more days following the onset of infection.
清查荷兰医院的术后感染情况。
描述性研究。
荷兰乌得勒支的全国医院质量保证组织。
在36家荷兰医院，采用标准化方法收集手术患者、手术部位感染及风险因素的数据，作为医院可将其感染率与数据库中感染率进行比较的质量体系的一部分。
36/118（31%）家医院引入了手术部位感染监测。收集了32869例手术的数据，发现1115例（3.4%）手术部位感染。按伤口污染等级划分的感染率，清洁伤口为2.2%（95%置信区间（CI）：2.0 - 2.4），污染伤口为11%（95%CI：9.3 - 12.8）；按手术时长划分的感染率，手术时长小于两小时的为3%（95%CI：2.8 - 3.2），手术时长超过8小时的为10.8%（95%CI：6.0 - 18.5）；按美国麻醉医师协会（ASA）分级划分的感染率，I级为2.7%（95%CI：2.3 - 3.2），IV级患者为15.5%（95%CI：8.4 - 26.5）。高龄、急诊、术前住院时间被确认为风险因素。最常记录的手术类型的感染率，静脉曲张手术为0.2%（95%CI：0.0 - 1.1），股动脉搭桥手术为9.8%（95%CI：7.2 - 13.2）。抗菌预防的使用因手术类型而异。最常分离出的微生物为金黄色葡萄球菌、表皮葡萄球菌、铜绿假单胞菌和大肠杆菌。32%的感染在术后第一周被识别。88%的感染患者在感染发生后的一天或多天内住院。
