An enhanced benchmark for prosthetic joint replacement infection rates.
BACKGROUND
The National Nosocomial Infection Surveillance System (NNIS) has historically provided the infection control community with the most accurate benchmark for healthcare-associated infections. However, NNIS does not require postdischarge surveillance. For medical centers where comprehensive postdischarge surveillance is possible, the efficiency of surgical site infection (SSI) detection is enhanced and rates may be higher than those provided by NNIS.


METHODS
From 1999 to 2004, a large integrated healthcare system (IHCS) used a standard surveillance methodology inclusive of the postdischarge period. This article compares IHCS and NNIS SSI data.


RESULTS
IHCS infection rates, stratified and weighted average (hip, 1.7; knee, 2.1) for the study period are higher than the corresponding NNIS rates (hip, 1.4; knee, 1.2) (hip, P = .006; knee, P = .012) when infections detected by the IHCS during the postdischarge period are included.


CONCLUSIONS
The data from the study period show that when comprehensive postdischarge surveillance is used by the IHCS, SSI rates are higher than those reflected in the NNIS database.
Barnes
Sue
S
Northern California Regional Infection Control, Kaiser Permanente, 1800 Harrison Street, Oakland, CA 94612, USA. sue.barnes@kp.org
Salemi
Charles
C
Fithian
Donald
D
Akiyama
Lois
L
Barron
Dana
D
Eck
Enid
E
Hoare
Kathy
K
D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000706:statistics & numerical data; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000706:statistics & numerical data; D019985:Benchmarking / Q000458:organization & administration*; D015982:Bias; D002487:Centers for Disease Control and Prevention, U.S.; D003625:Data Collection / Q000592:standards; D003627:Data Interpretation, Statistical; D016208:Databases, Factual / Q000592:standards; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D017598:Efficiency, Organizational; D017408:Guidelines as Topic; D006801:Humans; D017053:Infection Control / Q000458:organization & administration; D007902:Length of Stay / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology