An operating surveillance system of surgical-site infections in The Netherlands: results of the PREZIES national surveillance network. Preventie van Ziekenhuisinfecties door Surveillance.
OBJECTIVE
To describe the results of the first year of the Dutch national surveillance of surgical-site infections (SSIs) and risk factors, which aims to implement a standardized surveillance system in a network of Dutch hospitals, to collect comparable data on SSIs to serve as a reference, and to provide a basic infrastructure for further intervention research.


METHODS
Prospective multicenter cohort study.


METHODS
Acute-care hospitals in The Netherlands from June 1996 to May 1997.


RESULTS
38 hospitals participated, with a slight over-representation of larger hospitals. Following a total of 18,063 operations, 562 SSIs occurred, of which 198 were deep. Multivariate analysis of pooled procedures shows that age, preoperative length of stay, wound contamination class, anesthesia score, and duration of surgery were independent risk factors for SSI. When analyzed by procedure, the relative importance of these risk factors changed. Bacteriological documentation was available for 56% of the SSIs; 35% of all isolates were Staphylococcus aureus. Multiple regression analysis computed the mean extra postoperative length of stay associated with SSI to be 8.2 days.


CONCLUSIONS
The first year of national surveillance has shown that it is feasible to collect comparable data on SSI, which are already used for education, policy, and decision making in the network of participating hospitals. This gives room to effectuate the next aim, namely to use the network as an infrastructure for intervention research. Multivariate analysis shows that feedback on a procedure-specific level is important.
Geubbels
E L
EL
Department of Infectious Diseases Epidemiology, National Institute of Public Health and Environment (RIVM), BA Bilthoven, The Netherlands.
Mintjes-de Groot
A J
AJ
van den Berg
J M
JM
de Boer
A S
AS
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology; D015331:Cohort Studies; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D011787:Quality of Health Care; D012307:Risk Factors; D017678:Sex Distribution; D013203:Staphylococcal Infections / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology