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Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017
Introduction: The objective of the analysis was to determine the epidemiology of healthcare-associated infections (HAIs) in neurosurgical patients, paying special attention to two time points, 2003 and 2017, in order to evaluate the effectiveness of a surveillance program introduced in 2003 and effo...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466004/ https://www.ncbi.nlm.nih.gov/pubmed/30871283 http://dx.doi.org/10.3390/ijerph16060911 |
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author | Kołpa, Małgorzata Wałaszek, Marta Różańska, Anna Wolak, Zdzisław Wójkowska-Mach, Jadwiga |
author_facet | Kołpa, Małgorzata Wałaszek, Marta Różańska, Anna Wolak, Zdzisław Wójkowska-Mach, Jadwiga |
author_sort | Kołpa, Małgorzata |
collection | PubMed |
description | Introduction: The objective of the analysis was to determine the epidemiology of healthcare-associated infections (HAIs) in neurosurgical patients, paying special attention to two time points, 2003 and 2017, in order to evaluate the effectiveness of a surveillance program introduced in 2003 and efforts to reduce infection rates. Materials and methods: Continuous surveillance during 2003–2017 carried out using the HAI-Net methodology allowed us to detect 476 cases of HAIs among 10,332 patients staying in a 42-bed neurosurgery unit. The intervention in this before–after study (2003–2017) comprised standardized HAI surveillance with regular analysis and feedback. Results: The HAI incidence during the whole study was 4.6%. Surgical site infections (SSIs) accounted for 33% of all HAIs with an incidence rate of 1.5%. The remaining infections were pneumonia (1.1%) and bloodstream infections (0.9%). The highest SSI incidence concerned spinal fusion (FUSN, 2.2%), craniotomy (1.9%), and ventricular shunt (5.1%) while the associated total HAI incidence rates were 4.1%, 8.0%, and 18.6%, respectively. A significant reduction was found in HAI incidence between 2003 and 2017 in regard to the most common surgery types: laminectomy (4.5% vs. 0.8%); FUSN (11.8% vs. 0.8%); and craniotomy (10.1% vs. 0.4%). Significant changes were also achieved in selected elements of the unit’s work: pre-hospitalization duration, hospital stay, and surgery length reductions. Simultaneously, the general condition of patients became significantly worse: there was an increase in patients’ age and decreases in their general condition as expressed by ASA scores (The American Society of Anesthesiologists physical status classification system). Conclusions: HAI epidemiology changed substantially during the study period. Among the main types of HAI, SSIs were slightly predominant, but non-surgical HAIs accounted for almost two thirds of all infections; this indicates the need for surveillance of infection types other than SSIs in surgical patients. The implementation of active surveillance based on regular analysis and feedback led to a significant reduction in HAI incidence. |
format | Online Article Text |
id | pubmed-6466004 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-64660042019-04-22 Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017 Kołpa, Małgorzata Wałaszek, Marta Różańska, Anna Wolak, Zdzisław Wójkowska-Mach, Jadwiga Int J Environ Res Public Health Article Introduction: The objective of the analysis was to determine the epidemiology of healthcare-associated infections (HAIs) in neurosurgical patients, paying special attention to two time points, 2003 and 2017, in order to evaluate the effectiveness of a surveillance program introduced in 2003 and efforts to reduce infection rates. Materials and methods: Continuous surveillance during 2003–2017 carried out using the HAI-Net methodology allowed us to detect 476 cases of HAIs among 10,332 patients staying in a 42-bed neurosurgery unit. The intervention in this before–after study (2003–2017) comprised standardized HAI surveillance with regular analysis and feedback. Results: The HAI incidence during the whole study was 4.6%. Surgical site infections (SSIs) accounted for 33% of all HAIs with an incidence rate of 1.5%. The remaining infections were pneumonia (1.1%) and bloodstream infections (0.9%). The highest SSI incidence concerned spinal fusion (FUSN, 2.2%), craniotomy (1.9%), and ventricular shunt (5.1%) while the associated total HAI incidence rates were 4.1%, 8.0%, and 18.6%, respectively. A significant reduction was found in HAI incidence between 2003 and 2017 in regard to the most common surgery types: laminectomy (4.5% vs. 0.8%); FUSN (11.8% vs. 0.8%); and craniotomy (10.1% vs. 0.4%). Significant changes were also achieved in selected elements of the unit’s work: pre-hospitalization duration, hospital stay, and surgery length reductions. Simultaneously, the general condition of patients became significantly worse: there was an increase in patients’ age and decreases in their general condition as expressed by ASA scores (The American Society of Anesthesiologists physical status classification system). Conclusions: HAI epidemiology changed substantially during the study period. Among the main types of HAI, SSIs were slightly predominant, but non-surgical HAIs accounted for almost two thirds of all infections; this indicates the need for surveillance of infection types other than SSIs in surgical patients. The implementation of active surveillance based on regular analysis and feedback led to a significant reduction in HAI incidence. MDPI 2019-03-13 2019-03 /pmc/articles/PMC6466004/ /pubmed/30871283 http://dx.doi.org/10.3390/ijerph16060911 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Kołpa, Małgorzata Wałaszek, Marta Różańska, Anna Wolak, Zdzisław Wójkowska-Mach, Jadwiga Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017 |
title | Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017 |
title_full | Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017 |
title_fullStr | Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017 |
title_full_unstemmed | Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017 |
title_short | Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017 |
title_sort | epidemiology of surgical site infections and non-surgical infections in neurosurgical polish patients—substantial changes in 2003–2017 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466004/ https://www.ncbi.nlm.nih.gov/pubmed/30871283 http://dx.doi.org/10.3390/ijerph16060911 |
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