Surgical site infection rates following cardiac surgery: the impact of a 6-year infection control program.
BACKGROUND
To evaluate the impact of an infection control program on surgical site infections (SSIs) complicating cardiac operations.


METHODS
Prospective cohort study of patients undergoing cardiac operations. Interventions included prospective surveillance, povidone-iodine scrub showers, depilation before surgery, administration of preoperative antibiotic prophylaxis in the operating room, and postdischarge follow-up. Logistic regression models were fitted to assess infection rates over time, adjusting for factors known to affect SSI rates.


RESULTS
The overall SSI rate for 2051 procedures was 10.4%. Rates of superficial and deep incisional SSIs remained unchanged over the study period. The rates of all organ/space infections, mediastinitis, and SSIs because of methicillin-resistant Staphylococcus aureus during the first 2 years were 3.25%, 2.22%, and 1.48%, respectively, and they decreased to 1.17%, 0.73%, and 0.73%, respectively, by the end of 2002 (P = .01, P = .01, and P = .09, respectively). The adjusted odds ratios for these 3 types of infection at the end of 2002 compared with December 31, 1998, were 0.19 (95% confidence interval [95% CI]: 0.07-0.48), 0.20 (95% CI: 0.06-0.66), and 0.28 (95% CI: 0.08-0.97), respectively.


CONCLUSIONS
We observed significant reductions in organ/space infection rates, particularly mediastinitis. These differences remained significant when adjusted for potential confounding variables.
Finkelstein
Renato
R
Infectious Diseases Unit, Rambam Medical Center, Haifa, Israel. rfinkelstein@rambam.health.gov.il
Rabino
Galit
G
Mashiah
Tania
T
Bar-El
Yaron
Y
Adler
Zvi
Z
Kertzman
Victor
V
Cohen
Oved
O
Milo
Simcha
S
D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007297:Inpatients; D008480:Mediastinitis / Q000453:epidemiology / Q000382:microbiology; D016106:Methicillin Resistance; D013203:Staphylococcal Infections / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology; D013903:Thoracic Surgery