Surveillance and risk factors on hysterectomy wound infection rate in Gran Canaria, Spain.
OBJECTIVE
Surveillance programs for nosocomial infection control may find out opportunities for improvement. The aim of this study was to determine the incidence of surgical site infection and their potential risk factors after hysterectomy in a tertiary hospital in Gran Canaria, Spain.


METHODS
Prospective study on patients undergoing abdominal or vaginal hysterectomy between 1st June 2000 and 31st December 2004. Surgical site infection incidence rates were calculated according to procedure, and National Nosocomial Infection Surveillance (NNIS) system risk categories. We also reviewed antimicrobial prophylaxis use and morbidity. To determine associate risk factors a multivariate analysis was performed.


RESULTS
A total of 1540 women were surveyed; neoplasm (30.5%), obesity (24.3%), and diabetes (16.2%) grouped the main morbidity. About 81 cases (5.2%) met criteria for postoperative surgical site infection (6.0% for abdominal procedure and 3.1% for vaginal procedure). Most patients (86.4%) had adequate antimicrobial prophylaxis, but inadequacy was more frequent by vaginal (17.6%) than abdominal procedure (12.0%) (p=0.005). NNIS high-risk patients had significantly higher infection rates than did low-risk patients (p=0.01). The most common causative organism isolated was Escherichia coli (17.5%). Multivariate analysis showed obesity, inadequate antimicrobial prophylaxis, and abdominal procedure as the main risk factors.


CONCLUSIONS
Rate of surgical site infection is high. Enhanced and multidisciplinary efforts are needed.
Molina-Cabrillana
Jesús
J
Department of Preventive Medicine, Hospital Universitario Materno-Infantil, Las Palmas de Gran Canaria, Spain. jmolcab@gobiernodecanarias.org
Valle-Morales
Leonor
L
Hernandez-Vera
Juana
J
López-Carrió
Isabel
I
García-Hernández
J A
JA
Bolaños-Rivero
Margarita
M
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D015994:Incidence; D017053:Infection Control / Q000706:statistics & numerical data*; D016015:Logistic Models; D008875:Middle Aged; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology