Overall Burden of Healthcare-Associated Infections Among Surgical Patients: Results of a National Study.

Details

Serval ID
serval:BIB_DF062DD037FC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Overall Burden of Healthcare-Associated Infections Among Surgical Patients: Results of a National Study.
Journal
Annals of Surgery
Author(s)
Sax H., Uçkay I., Balmelli C., Bernasconi E., Boubaker K., Mühlemann K., Ruef C., Troillet N., Widmer A., Zanetti G., Pittet D.
ISSN
1528-1140 (Electronic)
ISSN-L
0003-4932
Publication state
Published
Issued date
2011
Volume
253
Number
2
Pages
365-370
Language
english
Abstract
OBJECTIVE:: To assess the overall burden of healthcare-associated infections (HAIs) in patients exposed and nonexposed to surgery. BACKGROUND:: Targeted HAI surveillance is common in healthcare institutions, but may underestimate the overall burden of disease. METHODS:: Prevalence study among patients hospitalized in 50 acute care hospitals participating in the Swiss Nosocomial Infection Prevalence surveillance program. RESULTS:: Of 8273 patients, 3377 (40.8%) had recent surgery. Overall, HAI was present in 358 (10.6%) patients exposed to surgery, but only in 206 (4.2%) of 4896 nonexposed (P < 0.001). Prevalence of surgical site infection (SSI) was 5.4%. Healthcare-associated infections prevalence excluding SSI was 6.5% in patients with surgery and 4.7% in those without (P < 0.0001). Patients exposed to surgery carried less intrinsic risk factors for infection (age >60 years, 55.6% vs 63.0%; American Society of Anesthesiologists score >3, 5.9% vs 9.3%; McCabe for rapidly fatal disease, 3.9% vs 6.6%; Charlson comorbidity index >2, 12.3% vs 20.9%, respectively; all P < 0.001) than those nonexposed, but more extrinsic risk factors (urinary catheters, 39.6% vs 14.1%; central venous catheters, 17.8% vs 7.1%; mechanical ventilation, 4.7% vs 1.3%; intensive care stay, 18.3% vs 8.8%, respectively; all P < 0.001). Exposure to surgery independently predicted an increased risk of HAI (odds ratio 2.43; 95% CI 2.0-3.0). CONCLUSIONS:: Despite a lower intrinsic risk, patients exposed to surgery carried more than twice the overall HAI burden than those nonexposed; almost half was accountable to SSI. Extending infection control efforts beyond SSI prevention in these patients might be rewarding, especially because of the extrinsic nature of risk factors.
Pubmed
Web of science
Create date
22/03/2011 9:01
Last modification date
20/08/2019 16:03
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