title: Development of a surgical site infection (SSI) surveillance system, calculation of SSI rates and specification of important factors affecting SSI in a digestive organ surgical department.
abstract: We have developed an original system to conduct surgical site infection (SSI) surveillance. This system accumulates SSI surveillance information based on the National Nosocomial Infections Surveillance (NNIS) System and the Japanese Nosocomial Infections Surveillance (JNIS) System. The features of this system are as follows: easy input of data, high generality, data accuracy, SSI rate by operative procedure and risk index category (RIC) can be promptly calculated and compared with the current NNIS SSI rate, and the SSI rates and accumulated data can be exported electronically. Using this system, we monitored 798 patients in 24 operative procedure categories in the Digestive Organs Surgery Department of Mazda Hospital, Mazda Motor Corporation, from January 2004 through December 2005. The total number and rate of SSI were 47 and 5.89%, respectively. The SSI rates of 777 patients were calculated based on 15 operative procedure categories and Risk Index Categories (RIC). The highest SSI rate was observed in the rectum surgery of RIC 1 (30%), followed by the colon surgery of RIC3 (28.57%). About 30% of the isolated infecting bacteria were Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Using quantification theory type 2, the American Society of Anesthesiology score (4.531), volume of hemorrhage under operation (3.075), wound classification (1.76), operation time (1.352), and history of diabetes (0.989) increased to higher ranks as factors for SSI. Therefore, we evaluated this system as a useful tool in safety control for operative procedures.
authors.affiliation: Laboratory of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Hiroshima International University, 5-1-1 Hirokoshingai, Kure-shi, Hiroshima 737-0112, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Kimura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Akagi
authors.forename: Kenji
authors.initials: K
authors.lastname: Kihira
mesh_terms: D003428:Cross Infection; D003625:Data Collection; D003627:Data Interpretation, Statistical; D041981:Gastrointestinal Tract / Q000382:microbiology* / Q000601:surgery*; D006761:Hospitals; D006801:Humans; D007564:Japan / Q000453:epidemiology; D015999:Multivariate Analysis; D011159:Population Surveillance; D011182:Postoperative Care / Q000592:standards*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*; D013997:Time Factors