Impact of lockdown for SARS-CoV-2 (COVID-19) on surgical site infection rates: a monocentric observational cohort study

被引:47
作者
Losurdo, Pasquale [1 ]
Paiano, Lucia [1 ]
Samardzic, Natasa [1 ]
Germani, Paola [1 ]
Bernardi, Laura [1 ]
Borelli, Massimo [1 ]
Pozzetto, Barbara [1 ]
de Manzini, Nicolo [1 ]
Bortul, Marina [1 ]
机构
[1] Univ Trieste, Hosp Cattinara, Dept Med & Surg Sci, Div Gen Surg, Str Fiume 447, I-34149 Trieste, Italy
关键词
Surgical site infections; SARS-CoV-2; COVID-19; Italy lockdown; RISK-FACTORS; COLORECTAL SURGERY; PREVENTION; ASSOCIATION; OUTCOMES; TRIAL;
D O I
10.1007/s13304-020-00884-6
中图分类号
R61 [外科手术学];
学科分类号
摘要
Surgical site infections are the most common in-hospital acquired infections. The aim of this study and the primary endpoint is to evaluate how the measures to reduce the SARS-CoV-2 spreading affected the superficial and deep SSI rate. A total of 541 patients were included. Of those, 198 from March to April 2018, 220 from March till April 2019 and 123 in the COVID-19 era from March to April 2020. The primary endpoint occurred in 39 over 541 patients. In COVID-19 era, we reported a lower rate of global SSIs (3.3% vs. 8.4%;p0.035), few patients developed a superficial SSIs (0.8% vs. 3.4%;p0.018) and none experienced deep SSIs (0% vs. 3.4%;p0.025). Comparing the previous two "COVID-19-free" years, no significative differences were reported. At multivariate analysis, the measures to reduce the SARS-CoV-2 spread (OR 0.368;p0.05) were independently associated with the reduction for total, superficial and deep SSIs. Moreover, the presence of drains (OR 4.99;p0.009) and a Type III-IV of SWC (OR 1.8;p0.001) demonstrated a worse effect regarding the primary endpoint. Furthermore, the presence of the drain was not associated with an increased risk of superficial and deep SSIs. In this study, we provided important insights into the superficial and deep SSIs risk assessment for patients who underwent surgery. Simple and easily viable precautions such as wearing surgical masks and the restriction of visitors emerged as promising tools for the reduction of SSIs risk.
引用
收藏
页码:1263 / 1271
页数:9
相关论文
共 36 条
[1]   Postoperative Surgical Site Infections Understanding the Discordance Between Surveillance Systems [J].
Ali-Mucheru, Mariam N. ;
Seville, Maria T. ;
Miller, Vickie ;
Sampathkumar, Priya ;
Etzioni, David A. .
ANNALS OF SURGERY, 2020, 271 (01) :94-99
[2]   Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update [J].
Anderson, Deverick J. ;
Podgorny, Kelly ;
Berrios-Torres, Sandra I. ;
Bratzler, Dale W. ;
Dellinger, E. Patchen ;
Greene, Linda ;
Nyquist, Ann-Christine ;
Saiman, Lisa ;
Yokoe, Deborah S. ;
Maragakis, Lisa L. ;
Kaye, Keith S. .
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2014, 35 (06) :605-627
[3]   Impact of surgical site infection on healthcare costs and patient outcomes: a systematic review in six European countries [J].
Badia, J. M. ;
Casey, A. L. ;
Petrosillo, N. ;
Hudson, P. M. ;
Mitchell, S. A. ;
Crosby, C. .
JOURNAL OF HOSPITAL INFECTION, 2017, 96 (01) :1-15
[4]   Surgical site infections after colorectal surgery: Do risk factors vary depending on the type of infection considered? [J].
Blumetti, Jennifer ;
Luu, Myda ;
Sarosi, George ;
Hartless, Kathleen ;
McFarlin, Jackie ;
Parker, Betty ;
Dineen, Sean ;
Huerta, Sergio ;
Asolati, Massimo ;
Varela, Esteban ;
Anthony, Thomas .
SURGERY, 2007, 142 (05) :704-711
[5]  
Broach RB, 2017, ANN SURG, V266, P946, DOI [10.1097/SLA.0000000000002189, 10.1097/sla.0000000000002189]
[6]   Intraoperative surgical site infection control and prevention: a position paper and future addendum to WSES intra-abdominal infections guidelines [J].
De Simone, Belinda ;
Sartelli, Massimo ;
Coccolini, Federico ;
Ball, Chad G. ;
Brambillasca, Pietro ;
Chiarugi, Massimo ;
Campanile, Fabio Cesare ;
Nita, Gabriela ;
Corbella, Davide ;
Leppaniemi, Ari ;
Boschini, Elena ;
Moore, Ernest E. ;
Biffl, Walter ;
Peitzmann, Andrew ;
Kluger, Yoram ;
Sugrue, Michael ;
Fraga, Gustavo ;
Di Saverio, Salomone ;
Weber, Dieter ;
Sakakushev, Boris ;
Chiara, Osvaldo ;
Abu-Zidan, Fikri M. ;
ten Broek, Richard ;
Kirkpatrick, Andrew W. ;
Wani, Imtiaz ;
Coimbra, Raul ;
Baiocchi, Gian Luca ;
Kelly, Micheal D. ;
Ansaloni, Luca ;
Catena, Fausto .
WORLD JOURNAL OF EMERGENCY SURGERY, 2020, 15 (01)
[7]   Risk factors and prediction model for inpatient surgical site infection after major abdominal surgery [J].
Ejaz, Aslam ;
Schmidt, Carl ;
Johnston, Fabian M. ;
Frank, Steve M. ;
Pawlik, Timothy M. .
JOURNAL OF SURGICAL RESEARCH, 2017, 217 :153-159
[8]   A Statewide Assessment of Surgical Site Infection Following Colectomy The Role of Oral Antibiotics [J].
Englesbe, Michael J. ;
Brooks, Linda ;
Kubus, James ;
Luchtefeld, Martin ;
Lynch, James ;
Senagore, Anthony ;
Eggenberger, John C. ;
Velanovich, Vic ;
Campbell, Darrell A., Jr. .
ANNALS OF SURGERY, 2010, 252 (03) :514-520
[9]   Discordance Between Perioperative Antibiotic Prophylaxis and Wound Infection Cultures in Patients Undergoing Pancreaticoduodenectomy [J].
Fong, Zhi Ven ;
McMillan, Matthew T. ;
Marchegiani, Giovanni ;
Sahora, Klaus ;
Malleo, Giuseppe ;
De Pastena, Matteo ;
Loehrer, Andrew P. ;
Lee, Grace C. ;
Ferrone, Cristina R. ;
Chang, David C. ;
Hutter, Matthew M. ;
Drebin, Jeffrey A. ;
Bassi, Claudio ;
Lillemoe, Keith D. ;
Vollmer, Charles M. ;
Fernandez-del Castillo, Carlos .
JAMA SURGERY, 2016, 151 (05) :432-439
[10]   Mechanical bowel preparation for elective colorectal surgery [J].
Gueenaga, Katia F. ;
Matos, Delcio ;
Wille-Jorgensen, Peer .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2011, (09)