title: Prevalence of surgical site infections before and after the implementation of a multimodal infection control programme.
abstract: OBJECTIVE
  In order to assess the prevalence of surgical site infections (SSIs) before and after the implementation of a multimodal infection control programme including the realization of a campaign to increase compliance with guidelines for antimicrobial prophylaxis, we designed and conducted the present study involving all 20 of the surgical departments of a large teaching hospital in Catania, Italy.
  
  
  METHODS
  SSI definitions of the Hospital in Europe Link for Infection Control through Surveillance (HELICS) protocol were used in four 1 day point-prevalence surveys. After the first survey, an infection control programme was implemented involving the active commitment of surgeons and infection control staff.
  
  
  RESULTS
  Overall, a total of 600 surgical patients were enrolled. A significant decreasing trend in the SSI rate (from 16.4 to 8.2 per 100 surgical patients, P=0.018) was shown. After multivariate analysis, significant risk factors for SSI were identified: age >31 years, kidney insufficiency and infection at admission. Taking into account the indication and the timing of administration of antibiotic prophylaxis, in the four surveys prophylaxis was administered inappropriately in 55.3% of surgical procedures.
  
  
  CONCLUSIONS
  The approach used in this study remains a feasible method of evaluating the burden of SSIs using repeated prevalence surveys. The results provide evidence of a significant decreasing trend in the SSI rate following the infection control intervention. Furthermore, our study underlines the need to develop evidence-based guidelines in collaboration with surgeons, to achieve consensus before implementation in order to improve compliance with antimicrobial prophylaxis and, finally, decrease SSI rates.
authors: Department GF Ingrassia, University of Catania, Catania, Italy.
authors: Martina
authors: M
authors: Barchitta
authors: Domenica
authors: D
authors: Matranga
authors: Annalisa
authors: A
authors: Quattrocchi
authors: Patrizia
authors: P
authors: Bellocchi
authors: Maria
authors: M
authors: Ruffino
authors: Guido
authors: G
authors: Basile
authors: Antonella
authors: A
authors: Agodi
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods / Q000592:standards; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006302:Health Services Research; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007558:Italy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents