title: Risk factors for surgical site infection in a Tanzanian district hospital: a challenge for the traditional National Nosocomial Infections Surveillance system index.
abstract: The incidence of surgical site infections (SSIs) was 24% in a district hospital in Tanzania. Wound classification was not an independent risk factor for SSI, indicating that risk scores developed in industrialized countries may require adjustments for nonindustrialized countries. The National Nosocomial Infections Surveillance system score required adjustments to reliably predict SSI, probably to account for improper hygiene and the lack of adjustment for the duration of surgery (defined as the 75th percentile of the duration for each type of operative procedure) to reflect local circumstances. Multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus and gram-negative pathogens expressing broad-spectrum beta-lactamases, have already emerged.
authors.affiliation: Department of Medicine and Diagnostics, Swiss Tropical Institute, Basel, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Fehr
authors.forename: Christoph
authors.initials: C
authors.lastname: Hatz
authors.forename: Isaac
authors.initials: I
authors.lastname: Soka
authors.forename: Patience
authors.initials: P
authors.lastname: Kibatala
authors.forename: Honorathy
authors.initials: H
authors.lastname: Urassa
authors.forename: Thomas
authors.initials: T
authors.lastname: Smith
authors.forename: Hassan
authors.initials: H
authors.lastname: Mshinda
authors.forename: Reno
authors.initials: R
authors.lastname: Frei
authors.forename: Andreas
authors.initials: A
authors.lastname: Widmer
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011159:Population Surveillance; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013636:Tanzania / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents