Emerging Infectious Diseases, noviembre 2004; 10(11): 1924-1930
Autores:

Yokoe Deborah S., Noskin Gary A., Cunningham Susan M., Zuccotti Gianna, Plaskett Theresa, Fraser Victoria J., Olsen Margaret A., Tokars Jerome I., Solomon Steven, Perl Trish M., Cosgrove Sara E., Tilson Richard S., Greenbaum Maurice, Hooper David C., Sands Kenneth E., Tully John, Herwaldt Loreen A., Diekema Daniel J., Wong Edward S., Climo Michael, Platt Richard

Abstract:

We evaluated antimicrobial exposure, discharge diagnoses, or both to identify surgical site infections (SSI). This retrospective cohort study in 13 hospitals involved weighted, random samples of records from 8,739 coronary artery bypass graft (CABG) procedures, 7,399 cesarean deliveries, and 6,175 breast procedures. We compared routine surveillance to detection through inpatient antimicrobial exposure (>9 days for CABG, >2 days for cesareans, and >6 days for breast procedures), discharge diagnoses, or both. Together, all methods identified SSI after 7.4% of CABG, 5.0% of cesareans, and 2.0% of breast procedures. Antimicrobial exposure had the highest sensitivity, 88%?91%, compared with routine surveillance, 38%?64%. Diagnosis codes improved sensitivity of detection of antimicrobial exposure after cesareans. Record review confirmed SSI after 31% to 38% of procedures that met antimicrobial
surveillance criteria. Sufficient antimicrobial exposure days, together with diagnosis codes for cesareans, identified more postoperative SSI than routine surveillance methods. This screening method was efficient, readily standardized,
and suitable for most hospitals.
Yokoe, Deborah S. ... [et al.]