Surveillance of Surgical Site Infections in Healthcare Facilities: ISO-Raisin Network, France. 2017 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 data 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). Surgical site infections (SSIs) are defined according to standard criteria. In 2017, participation in the surveillance of priority procedures remained largely unchanged from 2016: 364 facilities for 103,691 procedures monitored. The median number of specialties monitored per facility was 2 [1; 4] in 2017, compared to 3 [1; 4] in 2016. The distribution of specialties and their respective ISO incidence rates were: 239 orthopedic surgery facilities (ISO incidence rate = 1.37%), 213 gastrointestinal surgery facilities (1.97%), 194 gynecology and obstetrics facilities (1.88%), 67 trauma facilities (1.10%), 86 urology facilities (2.60%), 37 neurosurgery facilities (0.79%), 52 bariatric surgery facilities (1.72%), 13 coronary surgery centers (3.44%), 15 reconstructive surgery centers (3.99%), 11 thoracic surgery centers (1.32%), and 10 vascular surgery centers (2.32%). In 2017, there was an increase in the incidence rates of postoperative complications for abdominal wall hernias as well as for hip prosthesis revisions, and a decrease in the incidence rate of postoperative complications for transurethral resections of the prostate. The influence of Body Mass Index (BMI) on the incidence rate of SIS was demonstrated in orthopedic, digestive, gynecological-obstetric, and trauma surgeries; diabetes in orthopedic surgery; hypertension in orthopedic and digestive surgeries; and smoking. Prescribing antibiotic prophylaxis (AP) in accordance with the recommendations of the French Society of Anesthesia and Intensive Care (SFAR) was a protective factor in gynecological and obstetric surgery (compared to AP not in accordance with SFAR recommendations). Finally, the practice of hair removal was significantly associated with a lower rate of ISO in orthopedic surgery.

Author(s): Escutnaire-Marrant Tiphaine, Tanguy Juliette, Aupée Martine

Publishing year: 2019

Pages: 219 p.

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