title: Influence of a 5-year serial infection control and antibiotic stewardship intervention on cardiac surgical site infections.
abstract: Surgical site infections (SSIs) complicate surgery, resulting in higher morbidity and mortality. Infection control bundles and antibiotic stewardship can be effective at reducing SSIs. The influence of long-term serial interventions is unclear.
  
  
  
  The goal of this retrospective quasiexperimental study was to assess the influence of a 5-year serial infection control and antibiotic stewardship intervention on SSIs.
  
  
  
  The multidisciplinary program actively implemented pre-, intra-, and postoperative strategies over a 5-year period from 2009-2014 for all patients undergoing coronary artery bypass graft (CABG), valve replacement, or both at a tertiary care public institution. Outcomes are compared with a 2-year preinterventions period (2007-2009) and 1-year postinterventions period (2014-2015).
  
  
  
  A total of 6,518 procedures were included. After interventions, the overall combined infection rate for CABG, CABG and valve, and valve procedures decreased by 66.3%, from 11.9%-4.0% (odds ratio, 0.34; 95% confidence interval, 0.23-0.49; P < .001). A significant decrease of >50% (P < .001) relative rate was observed in overall, sternum, leg, CABG, and combined CABG and valve infection rates when comparing pre- and postinterventions groups. The antibiotic stewardship intervention increased overall conformity to the internal surgical prophylaxis protocol by 46.8%, from 39.8%-86.6% (95% confidence interval, 41.0-52.4; P < .001).
  
  
  
  Long-term, serial comprehensive infection control and antibiotic stewardship interventions decrease overall SSIs in patients undergoing CABG and valve replacement procedures.
authors.affiliation: Infectious Diseases Department, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Charles
authors.initials: C
authors.lastname: Frenette
authors.affiliation: Faculte de pharmacie, Université de Montreal, Montreal, Quebec, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Sperlea
authors.affiliation: Faculte de pharmacie, Université de Montreal, Montreal, Quebec, Canada.
authors.forename: Joey
authors.initials: J
authors.lastname: Tesolin
authors.affiliation: Infection Prevention and Control Department, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, Canada.
authors.forename: Connie
authors.initials: C
authors.lastname: Patterson
authors.affiliation: Faculte de pharmacie, Université de Montreal, Montreal, Quebec, Canada; Pharmacy Department, Royal Victoria Hospital, McGill University Health Center, Montreal, Quebec, Canada. Electronic address: Daniel.thirion@umontreal.ca.
authors.forename: Daniel J G
authors.initials: DJ
authors.lastname: Thirion
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D015995:Prevalence; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control*; D062606:Tertiary Care Centers
chemical_list: D000900:Anti-Bacterial Agents
keywords: Aminoglycoside; Antibiotic prophylaxis; Cardiac surgical procedures; Infection control; Surgical wound infection