Validation of surgical site infection surveillance in orthopedic procedures

被引:31
作者
Huotari, Kaisa
Agthe, Niina
Lyytikainen, Outi
机构
[1] Natl Publ Hlth Inst, Helsinki, Finland
[2] Univ Helsinki, Cent Hosp, Dept Med, Div Infect Dis, Helsinki, Finland
关键词
D O I
10.1016/j.ajic.2006.01.009
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Valid data are essential for a national surveillance system of nosocomial infections. Methods: In 8 hospitals conducting surgical site infection (SSI) surveillance for orthopedic procedures, a validation team performed a blinded retrospective chart review (10 operations with reported infections, 40 without) and interviewed infection control nurses. Results: In total, 397 patient charts were reviewed. Positive and negative predictive values for routine surveillance were 94 % (95 % CI: 89 %-99 %) and 99 % (95 % CI: 99 %-100 %), respectively When these results were applied to the aggregated surveillance data (403 infections, 10,068 noninfections), sensitivity was 75 % (95 % CI: 56 %-93 %) and specificity 100 % (95 % CI: 97 %-100 %). The following case finding methods were used: ward visits (in 7/8 hospitals), microbiology reports (5/8), ward notifications by link nurses (8/8), and other nursing (718) and medical (5/8) staff. The wound culture rate ranged from 9 to 67 per 1000 patient-days. All hospitals carried out postdischarge surveillance on readmission and all but I at follow-up visits and by an additional questionnaire. Conclusion: Most SSIs reported by the hospitals were true infections, showing that, when an SSI was reported, the definitions were correctly implemented. Some SSIs were missed, which might be due to weaknesses in case finding. Variation in diagnostic practices may also affect SSI rates.
引用
收藏
页码:216 / 221
页数:6
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