title: Active prospective surveillance study with post-discharge surveillance of surgical site infections in Cambodia.
abstract: Barriers to the implementation of the Centers for Disease Control and Prevention (CDC) guidelines for surgical site infection (SSI) surveillance have been described in resource-limited settings. This study aimed to estimate the SSI incidence rate in a Cambodian hospital and to compare different modalities of SSI surveillance. We performed an active prospective study with post-discharge surveillance. During the hospital stay, trained surveyors collected the CDC criteria to identify SSI by direct examination of the surgical site. After discharge, a card was given to each included patient to be presented to all practitioners examining the surgical site. Among 167 patients, direct examination of the surgical site identified a cumulative incidence rate of 14 infections per 100 patients. An independent review of medical charts presented a sensitivity of 16%. The sensitivity of the purulent drainage criterion to detect SSIs was 83%. After hospital discharge, 87% of the patients provided follow-up data, and nine purulent drainages were reported by a practitioner (cumulative incidence rate: 20%). Overall, the incidence rate was dependent on the surveillance modalities. The review of medical charts to identify SSIs during hospitalization was not effective; the use of a follow-up card with phone calls for post-discharge surveillance was effective.
authors.affiliation: Preah Kossamak Hospital, 271 Sangkat Teuk Loak II Street, Khan Tuol Kok, Phnom Penh City, Cambodia. Electronic address: j.guerra.sp@gmail.com.
authors.forename: José
authors.initials: J
authors.lastname: Guerra
authors.affiliation: Prupet NGO, Centre Hospitalier Moulins, 10, Avenue Général de Gaulle, 03006 Moulins Cedex, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Guichon
authors.affiliation: Preah Kossamak Hospital, 271 Sangkat Teuk Loak II Street, Khan Tuol Kok, Phnom Penh City, Cambodia.
authors.forename: Margaux
authors.initials: M
authors.lastname: Isnard
authors.affiliation: Preah Kossamak Hospital, 271 Sangkat Teuk Loak II Street, Khan Tuol Kok, Phnom Penh City, Cambodia.
authors.forename: Saphy
authors.initials: S
authors.lastname: So
authors.affiliation: Preah Kossamak Hospital, 271 Sangkat Teuk Loak II Street, Khan Tuol Kok, Phnom Penh City, Cambodia.
authors.forename: Sophors
authors.initials: S
authors.lastname: Chan
authors.affiliation: Prupet NGO, Centre Hospitalier Moulins, 10, Avenue Général de Gaulle, 03006 Moulins Cedex, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Couraud
authors.affiliation: Preah Kossamak Hospital, 271 Sangkat Teuk Loak II Street, Khan Tuol Kok, Phnom Penh City, Cambodia.
authors.forename: Bunn
authors.initials: B
authors.lastname: Duong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D062665:Epidemiological Monitoring; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology*; D055815:Young Adult
keywords: Cambodia; Developing countries; Feasibility studies; Follow-up studies; Infection control; Surgical wound infection