Surgical site infection after valvular or coronary artery bypass surgery: 2008–2011 French SSI national ISO-RAISIN surveillance. Issue 3 (November 2015)

• Record Type: Journal Article
• Authors: Cossin, S.; Malavaud, S.; Jarno, P.; Giard, M.; L'Hériteau, F.; Simon, L.; Bieler, L.; Molinier, L.; Marcheix, B.; Venier, A.-G.; the ISO-RAISIN Steering Committee, †
• Is Part Of: Journal of hospital infection. Volume 91:Issue 3(2015)
• Page Start: 225
• Page End: 230
• Publication Date: 2015-11
• Subjects: Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2015.07.001
• Languages: English
• ISSNs: 0195-6701

Abstract

<abstract xml:lang="en" abstract-type="author" id="abs0010"> <title id="sectitle0010">Summary</title> <sec> <title id="sectitle0015">Background</title> <p id="abspara0010">Multisite information regarding surgical site infection (SSI) rates for cardiac surgery programmes is not widely available. Ward characteristics that may affect outcomes have not been analysed previously.</p> </sec> <sec> <title id="sectitle0020">Aim</title> <p id="abspara0015">To determine individual- and ward-level factors associated with SSI occurrence after coronary artery bypass grafting (CABG) and valvular surgery.</p> </sec> <sec> <title id="sectitle0025">Methods</title> <p id="abspara0020">A dataset from the French national SSI database ISO-RAISIN 2008–2011 was used. Only adult patients were included. A standardized questionnaire was completed for each patient who underwent surgery, and patients with and without SSI were characterized. Patients and ward risk factors for SSI were analysed using a multilevel logistic regression model with SSI as binary outcome (two levels: patient and ward).</p> </sec> <sec> <title id="sectitle0030">Results</title> <p id="abspara0025">Out of 8569 patients from 39 wards, the SSI rate was 2.2%. Micro-organisms were isolated in 144 patients (74%): 35% coagulase-negative staphylococci (<italic>N</italic> = 51), 23% <italic>Staphylococcus aureus</italic> (<italic>N</italic> = 33), 6% <italic>Escherichia coli</italic> (<italic>N</italic> = 8). Higher probability of SSI was associated with the duration of preoperative hospitalization, the duration of follow-up, the duration of surgery >75th percentile and the SSI rate in the surgery ward. The residual heterogeneity between wards (median odds ratio: 1.53) was as relevant as duration of preoperative hospitalization (odds ratio: 1.57).</p> </sec> <sec> <title id="sectitle0035">Conclusion</title> <p id="abspara0030">Although patient risk factors were more strongly associated with SSI occurrence, this study provided evidence for the existence of a ward-level effect. This should be taken into account when considering possible corrective interventions.</p> </sec> </abstract>