Surveillance of surgical site infections at a tertiary care hospital in Greece: incidence, risk factors, microbiology, and impact.
BACKGROUND
In this first attempt to implement a standardized surveillance system of surgical site infections (SSI) in a Greek hospital, our objective was to identify areas for improvement by comparing main epidemiologic and microbiologic features of SSI with international data.


METHODS
The National Nosocomial Infections Surveillance (NNIS) system protocols were employed to prospectively collect data for patients in 8 surgical wards who underwent surgery during a 9-month period. SSI rates were benchmarked with international data using standardized infection ratios. Risk factors were evaluated by multivariate logistic regression.


RESULTS
A total of 129 SSI was identified in 2420 operations (5.3%), of which 47.3% developed after discharge. SSI rates were higher for 2 of 20 operation categories compared with Spanish and Italian data and for 12 of 20 categories compared with NNIS data. Gram-positive microorganisms accounted for 52.1% of SSI isolates, and Enterococci were predominant. Alarming resistance patterns for Enterococcus faecium and Acinetobacter baumannii were recorded. Potentially modifiable risk factors for SSI included multiple procedures, extended duration of operation, and antibiotic prophylaxis. SSI was associated with prolongation of postoperative stay but not with mortality.


CONCLUSIONS
Comparisons of surveillance data in our hospital with international benchmarks provided useful information for infection control interventions to reduce the incidence of SSI.
Laboratory of Clinical Bacteriology, Parasitology, Zoonosis and Geographical Medicine, University of Crete, Crete, Greece.
Maria
M
Roumbelaki
Evangelos I
EI
Kritsotakis
Constantinos
C
Tsioutis
Penelope
P
Tzilepi
Achilleas
A
Gikas
D040981:Acinetobacter baumannii / Q000302:isolation & purification; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D019985:Benchmarking; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D016984:Enterococcus faecium / Q000302:isolation & purification; D005260:Female; D006115:Greece / Q000453:epidemiology; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000382:microbiology; D011446:Prospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
D000900:Anti-Bacterial Agents