title: Cross-sectional study on surveillance of surgical site infections after vascular surgery.
abstract: OBJECTIVE
  To determine the incidence and risk factors for surgical site infections (SSI) after vascular surgery, to evaluate the Dutch safety bundle to reduce adverse complications and to analyze causative microorganisms of SSIs.
  
  
  METHODS
  The 3.5-year study was divided into two periods: the control period (before bundle implementation) and intervention period (after implementation). Postdischarge surveillance was performed until 30 days after surgery. Causative microorganisms from in-hospital wound swabs were determined. SSI rates between both periods were compared and a risk analysis was carried out by performing a logistic regression.
  
  
  RESULTS
  The study included 1719 operations. The in-hospital SSI rate increased significantly over time. Out of 140 SSIs, 39% were diagnosed postdischarge. Risk factors were diabetes, age >60 years and operations classified as contaminated or dirty. Pseudomonas aeruginosa susceptibility was the highest for gentamicin (97%). All Staphylococcus aureus were methicillin susceptible.
  
  
  CONCLUSIONS
  As patient demographics are important to determine the effectiveness of infection preventive measures, (postdischarge) surveillance is important for developing SSI interventions.
authors.affiliation: Maastricht University Medical Centre, Department of Medical Microbiology, P Debyelaan 25, 6229 HX Maastricht, The Netherlands.
authors.forename: Amita
authors.initials: A
authors.lastname: Ramcharan
authors.forename: John
authors.initials: J
authors.lastname: Penders
authors.forename: Ed
authors.initials: E
authors.lastname: Smeets
authors.forename: Margriet
authors.initials: M
authors.lastname: Rouflart
authors.forename: Frank van
authors.initials: Fv
authors.lastname: Tiel
authors.forename: Cathrien
authors.initials: C
authors.lastname: Bruggeman
authors.forename: Cor
authors.initials: C
authors.lastname: Baeten
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Breukink
authors.forename: Jan
authors.initials: J
authors.lastname: Tordoir
authors.forename: Ellen
authors.initials: E
authors.lastname: Stobberingh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D062665:Epidemiological Monitoring; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011550:Pseudomonas aeruginosa / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D014652:Vascular Diseases / Q000601:surgery*; D055815:Young Adult