Reducing surgical site infection incidence through a network: results from the French ISO-RAISIN surveillance system
Reducing surgical site infection incidence through a network: results from the French ISO-RAISIN surveillance system
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DOI：
10.1016/j.jhin.2009.03.005
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发表时间：
2009-06-01
影响因子：
6.9
通讯作者：
Coignard, B.
中科院分区：
文献类型：
--
作者：
Astagneau, P.;L'Heriteau, F.;Coignard, B.
手术部位感染（SSI）是医院感染控制计划的一个关键目标。我们评估了名为 ISO-RAISIN（操作现场感染 - Reseau Alerte Investigation Surveillance des Infections）的为期八年的国家 SSI 监测系统的影响。每年三个月内连续接受手术的患者被纳入研究，并在手术后 30 天进行调查。为每位患者填写一份标准化表格，包括根据标准标准进行的 SSI 诊断，以及伤口类别、美国麻醉医师协会 (ASA) 评分、手术持续时间、择期/紧急手术和手术类型等几个危险因素。从 1999 年到 2006 年，在 838 家参与医院接受手术的 964 128 名患者中发现了 14 845 例 SSI（总体粗发生率：1.54%）。粗略总体 SSI 发生率从 2.04% 下降至 1.26%（P < 0.001；相对降低：-38%），国家医院感染监测系统 (NNIS)-0 将 SSI 发生率从 1.10% 调整至 0.74%（P < 0.001；相对降低：-33%）。疝修补术和剖腹产术中观察到 SSI 发生率降低最显着，胆囊切除术、髋关节假体成形术和乳房切除术的发生率降低幅度较小。在整个网络中争取基准的主动监控是减少 SSI 发生率的有效策略。 (C) 2009 年医院感染协会。由爱思唯尔有限公司出版。保留所有权利。
Surgical-site infections (SSIs) are a key target for nosocomial infection control programmes. We evaluated the impact of an eight-year national SSI surveillance system named ISO-RAISIN (infection du site operatoire - Reseau Alerte Investigation Surveillance des Infections). Consecutive patients undergoing surgery were enrolled during a three-month period each year and surveyed for 30 days following surgery. A standardised form was completed for each patient including SSI diagnosis according to standard criteria, and several risk factors such as wound class, American Society of Anesthesiologists (ASA) score, operation duration, elective/emergency surgery, and type of surgery. From 1999 to 2006, 14 845 SSIs were identified in 964 128 patients (overall crude incidence: 1.54%) operated on in 838 participating hospitals. The crude overall SSI incidence decreased from 2.04% to 1.26% (P < 0.001; relative reduction: -38%) and the National Nosocomial Infections Surveillance system (NNIS)-0 adjusted SSI incidence from 1.10% to 0.74% (P < 0.001; relative reduction: -33%). The most significant SSI incidence reduction was observed for hernia repair and caesarean section, and to a lesser extent, cholecystectomy, hip prosthesis arthroplasty, and mastectomy. Active surveillance striving for a benchmark throughout a network is an effective strategy to reduce SSI incidence. (C) 2009 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.