Sixteen years' surveillance of surgical sites in an Irish acute-care hospital.
OBJECTIVE
To report a program of continuous surveillance of surgical-site infections (SSIs) using basic surveillance methods.


METHODS
Analysis of routine prospective surveillance data.


METHODS
Two hospitals in Ireland (300 and 350 beds) that merged and moved to a new 650-bed hospital in 1987.


METHODS
59,335 surgical sites of postoperative patients.


METHODS
Surgical sites were surveyed by one infection control nurse and SSI rates were produced for selected operations and surgical services. The program was conducted in general accordance with the 1999 HICPAC guidelines, but differed in surveillance strategy. Operations were limited to two to three risk classifications, assigned by the infection control nurse.


RESULTS
The overall SSI rate was 4.5%, with 2.4% in clean surgery. Apart from increases in the 3rd, 4th, 13th, and 14th years, rates remained relatively stable during the 16 years. Few significant decreases in SSI rates in surgical services or specific operations were shown, apart from the following: vascular surgery, 8.1% to 5% between the first 8 years and the last 8 years; general surgery services, 9% to 5%, and gynecology, 15.8% to 1.7%, both in the first year compared with in subsequent years; and gastric operations, 21% to 4.3% between the first year and the second year. Organ/space infection was identified in 0.5% of 17,804 operations, including 0.4% meningitis after neurosurgical procedures, 3% graft infections after vascular bypass operations, and 0.2% intra-abdominal infections after abdominal surgery.


CONCLUSIONS
With the use of basic principles of surveillance and modest resources, procedure-specific SSI rates were produced, with little significant change during the 16 years. Despite limitations in case-finding, risk stratification, feedback, and surveillance methods, the overall SSI rates were comparable with other published data.
Creamer
Eilish
E
Department of Infection Control and Clinical Microbiology, Beaumont Hospital, Dublin, Ireland.
Cunney
Robert J
RJ
Humphreys
Hilary
H
Smyth
Edmond G
EG
D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D016357:Infection Control Practitioners; D007494:Ireland / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D018571:Sentinel Surveillance; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control