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Epidemiology of Surgical Site Infection in a Community Hospital Network

Published online by Cambridge University Press:  11 February 2016

Arthur W. Baker ,
Kristen V. Dicks ,
Michael J. Durkin ,
David J. Weber ,
Sarah S. Lewis ,
Rebekah W. Moehring ,
Luke F. Chen ,
Daniel J. Sexton  and
Deverick J. Anderson
Arthur W. Baker*
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
Kristen V. Dicks
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
Michael J. Durkin
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
David J. Weber
Affiliation:
Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
Sarah S. Lewis
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Rebekah W. Moehring
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina Durham Veterans Affairs Medical Center, Durham, North Carolina
Luke F. Chen
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Daniel J. Sexton
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Deverick J. Anderson
Affiliation:
Department of Medicine, Division of Infectious Diseases, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
*
Address correspondence to Arthur W. Baker, MD, MPH, Duke University Medical Center, Box 102359, Room 181 Hanes House, Durham, NC 27710 (Arthur.Baker@duke.edu).
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Abstract

OBJECTIVE

To describe the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens

METHODS

We prospectively collected SSI data at 29 community hospitals in the southeastern United States from 2008 through 2012. We determined the overall prevalence rates of SSI for commonly performed procedures during this 5-year study period. For each year of the study, we then calculated prevalence rates of SSI stratified by causative organism. We created log-binomial regression models to analyze trends of SSI prevalence over time for all pathogens combined and specifically for MRSA.

RESULTS

A total of 3,988 complex SSIs occurred following 532,694 procedures (prevalence rate, 0.7 infections per 100 procedures). SSIs occurred most frequently after small bowel surgery, peripheral vascular bypass surgery, and colon surgery. Staphylococcus aureus was the most common pathogen. The prevalence rate of SSI decreased from 0.76 infections per 100 procedures in 2008 to 0.69 infections per 100 procedures in 2012 (prevalence rate ratio [PRR], 0.90; 95% confidence interval [CI], 0.82–1.00). A more substantial decrease in MRSA SSI (PRR, 0.69; 95% CI, 0.54–0.89) was largely responsible for this overall trend.

CONCLUSIONS

The prevalence of MRSA SSI decreased from 2008 to 2012 in our network of community hospitals. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence over the study period.

Infect Control Hosp Epidemiol 2016;37:519–526

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 5 , May 2016 , pp. 519 - 526
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

PREVIOUS PRESENTATION: An abstract containing preliminary data was presented at IDWeek 2014, October 10, 2014, Philadelphia, Pennsylvania.

References

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