Surveillance of Surgical Site Infections in French Healthcare Facilities: 2016 Results
Reducing the incidence of surgical site infections (SSIs) is one of the objectives of the national program to combat nosocomial infections (NI). Since 1999, interregional surveillance of SSIs has been coordinated by the Network for Alert, Investigation, and Surveillance of Nosocomial Infections (RAISIN). Each year, healthcare facilities performing surgical procedures voluntarily collect information from a list of "priority" specialties regarding the patient and the procedure, including components of the National Nosocomial Infections Surveillance (NNIS) risk index. All included patients must be followed up through the 30th postoperative day (90 days for procedures involving prostheses). SSI cases are defined according to standard criteria. In 2016, the number of facilities participating in the surveillance of priority procedures remained largely unchanged compared to 2015: 357 facilities for 111,198 procedures. The median number of specialties monitored per facility was 3 [1; 4] in 2016, compared to 2 [1; 4] in 2015. The specialties most frequently monitored in 2016 compared to 2015 were gynecological and obstetric surgery (+11%), lower extremity venous excision surgery (+13%), bariatric surgery (+31%), and reconstructive surgery (+160%). The breakdown of specialties and their respective ISO rates were: 213 digestive surgery facilities (ISO rate = 1.59%), 255 orthopedic surgery facilities (1.27%), 196 gynecology and obstetrics facilities (1.81%), 69 trauma facilities (1.12%), 85 lower limb vein removal surgery facilities (0.63%), 80 urology facilities (3.03%), 51 bariatric surgery facilities (1.21%), 40 neurosurgery facilities (0.92%), 10 coronary surgery facilities (3.81%), 9 thoracic surgery facilities (1.75%), and 13 reconstructive surgery facilities (3.53%). As noted in previous years, not only has the slowing of the decline in incidence been confirmed, but in 2016, an increase in SSI rates was observed for abdominal wall hernias, primary knee replacements, and lower extremity vein excisions. The influence of Body Mass Index (BMI) on the incidence rate of SSI was demonstrated in gastrointestinal, orthopedic, and gynecological-obstetric surgery; diabetes in coronary surgery; and hypertension in gastrointestinal surgery. Prescribing antibiotic prophylaxis (AP) in accordance with the recommendations of the French Society of Anesthesia and Intensive Care (SFAR) was a protective factor in gastrointestinal surgery (compared to AP not in accordance with SFAR recommendations). Finally, hair removal by shaving was significantly associated with a higher rate of ISO in digestive surgery compared to hair removal by clipping, scissors, or chemical methods.
Publishing year: 2018
Pages: 223 p.
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