Targeted Surveillance and Risk Factors Analysis on Surgical Site Infection after Colorectal Resections_West China Medical Journal

Authors：

 LIShi-yu ¹ , HUANGWen-zhi ¹ , QIAOFu ¹ , LIMing-xia ² ,  YINWei-jia ¹

1. Department of Nosocomial Infection Management, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Ward 2, Gastrointestinal Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

YINWei-jia, Email: 525989261@qq.com

Keywords：

Colorectal surgery; Targeted surveillance; Surgical site infection; Risk factor

DOI：

10.7507/1002-0179.20150316

Video：

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Objective To investigate the risk factors for surgical site infection (SSI) in patients after colorectal surgery, in order to provide a basis for regulation and implementation of preventive measures against SSI. Methods From February to December 2012, a targeted surveillance on surgical site infection of "colon resection" and "rectum resection" surgery patients in the Department of Gastrointestinal Surgery was carried out. We analyzed the monitoring data, and explored the occurrence of postoperative SSI. At the same time, by case-control study, both single and multiple regression logistic analyses were performed on the 12 variables such as hypertension, diabetes mellitus duration during operation, America Society of Anesthesiologists score, grade of incision and so on to analyze the risk factors for SSI. Results Among the 535 patients who underwent colorectal resections, 44 had SSI with an infection rate of 8.22%. Multiple logistic regression analysis showed that the length of hospital stay[OR=1.070,95%CI(1.033,1.109), P<0.001]and emergency surgery[OR=6.320,95%CI(1.932,20.669),P=0.002] were independent risk factors for SSI after colorectal resections. Conclusion There are many risk factors for SSI after colorectal surgery. Through the implementation of targeted surveillance, we can find the main risk factors, which provides a basis for the regulation and implementation of intervention measures against SSI.

Citation： LIShi-yu, HUANGWen-zhi, QIAOFu, LIMing-xia, YINWei-jia. Targeted Surveillance and Risk Factors Analysis on Surgical Site Infection after Colorectal Resections. West China Medical Journal, 2015, 30(6): 1105-1108. doi: 10.7507/1002-0179.20150316 Copy

1.	Weiss CA 3rd, Statz CL, Dahms RA, et al. Six years of surgical wound infection surveillance at a tertiary care center:review of the microbiologic and epidemiological aspects of 20,007 wounds[J]. Arch Surg, 1999, 134(10):1041-1048.
2.	Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee[J]. Infect Control Hosp Epidemiol, 1999, 20(4):250-278; quiz 279-280.
3.	吳安華, 任南, 文細毛, 等. 159所醫院醫院感染現患率調查結果與分析[J]. 中國感染控制雜志, 2005(1):12-17.
4.	De Lissovoy G, Fraeman K, Hutchins VA, et al. Surgical site infection:incidence and impact on hospital utilization and treatment costs[J]. Am J Infect Control, 2009, 37(5):387-397.
5.	Hagihara M, Suwa M, Ito Y, et al. Preventing surgical-site infections after colorectal surgery[J]. J Infect Chemother, 2012, 18(1):83-89.
6.	de Oliveira AC, Ciosak SI, Ferraz EM, et al. Surgical site infection in patients submitted to digestive surgery:risk prediction and the NNIS risk index[J]. Am J Infect Control, 2006, 34(4):201-207.
7.	Smith RL, Bohl JK, McElearney ST, et al. Wound infection after elective colorectal resection[J]. Ann Surg, 2004, 239(5):599-605.
8.	Pryor KO, Fahey TJ, Lien CA, et al. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population:a randomized controlled trial[J]. JAMA, 2004, 291(1):79-87.
9.	Brandstrup B, T?nnesen H, Beier-Holgersen R, et al. Effects of intravenous fluid restriction on postoperative complications:comparison of two perioperative fluid regimens:a randomized assessor-blinded multicenter trial[J]. Ann Surg, 2003, 238(5):641-648.
10.	Itani KM, Wilson SE, Awad SS, et al. Ertapenem versus cefotetan prophylaxis in elective colorectal surgery[J]. N Engl J Med, 2006, 355(25):2640-2651.
11.	中華人民共和國衛生部. 醫院感染診斷標準(試行)[J]. 中華醫學雜志, 2001, 81(5):314-320.
12.	中華人民共和國衛生部辦公廳. 《外科手術部位感染預防與控制技術指南(試行)[EB/OL].(2010-12-14)[2014-09-01]. http://www.moh.gov.cn/mohyzs/s3594/201012/50039.shtml.
13.	Woodfield JC, Beshay NM, Pettigrew RA, et al. American Society of Anesthesiologists classification of physical status as a predictor of wound infection[J]. ANZ J Surg, 2007, 77(9):738-741.
14.	中華人民共和國衛生部. 醫院感染監測規范[J]. 中華醫院感染學雜志, 2009, 19(11):Ⅰ-Ⅱ.
15.	Stotts NA, Whitney JD. Identifying and evaluating wound infection[J]. Home Healthc Nurse, 1999, 17(3):159-164.
16.	Granick M, Gameli R. Surgical wound healing and management[M]. New York:Informa Healthcare USA, 2007.
17.	趙嵐, 王平. 外科手術部位感染的危險因素分析[J]. 中華臨床感染病雜志, 2009, 6(2):179-181.
18.	肖漢強, 黃秀良. 外科手術切口感染監測分析與控制[J]. 中華醫院感染學雜志, 2010, 20(2):204-206.
19.	Astagneau P, L'Hériteau F, Daniel F, et al. Reducing surgical site infection incidence through a network:results from the French ISO-RAISIN surveillance system[J]. J Hosp Infect, 2009, 72(2):127-134.

1. Weiss CA 3rd, Statz CL, Dahms RA, et al. Six years of surgical wound infection surveillance at a tertiary care center:review of the microbiologic and epidemiological aspects of 20,007 wounds[J]. Arch Surg, 1999, 134(10):1041-1048.
2. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee[J]. Infect Control Hosp Epidemiol, 1999, 20(4):250-278; quiz 279-280.
3. 吳安華, 任南, 文細毛, 等. 159所醫院醫院感染現患率調查結果與分析[J]. 中國感染控制雜志, 2005(1):12-17.
4. De Lissovoy G, Fraeman K, Hutchins VA, et al. Surgical site infection:incidence and impact on hospital utilization and treatment costs[J]. Am J Infect Control, 2009, 37(5):387-397.
5. Hagihara M, Suwa M, Ito Y, et al. Preventing surgical-site infections after colorectal surgery[J]. J Infect Chemother, 2012, 18(1):83-89.
6. de Oliveira AC, Ciosak SI, Ferraz EM, et al. Surgical site infection in patients submitted to digestive surgery:risk prediction and the NNIS risk index[J]. Am J Infect Control, 2006, 34(4):201-207.
7. Smith RL, Bohl JK, McElearney ST, et al. Wound infection after elective colorectal resection[J]. Ann Surg, 2004, 239(5):599-605.
8. Pryor KO, Fahey TJ, Lien CA, et al. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population:a randomized controlled trial[J]. JAMA, 2004, 291(1):79-87.
9. Brandstrup B, T?nnesen H, Beier-Holgersen R, et al. Effects of intravenous fluid restriction on postoperative complications:comparison of two perioperative fluid regimens:a randomized assessor-blinded multicenter trial[J]. Ann Surg, 2003, 238(5):641-648.
10. Itani KM, Wilson SE, Awad SS, et al. Ertapenem versus cefotetan prophylaxis in elective colorectal surgery[J]. N Engl J Med, 2006, 355(25):2640-2651.
11. 中華人民共和國衛生部. 醫院感染診斷標準(試行)[J]. 中華醫學雜志, 2001, 81(5):314-320.
12. 中華人民共和國衛生部辦公廳. 《外科手術部位感染預防與控制技術指南(試行)[EB/OL].(2010-12-14)[2014-09-01]. http://www.moh.gov.cn/mohyzs/s3594/201012/50039.shtml.
13. Woodfield JC, Beshay NM, Pettigrew RA, et al. American Society of Anesthesiologists classification of physical status as a predictor of wound infection[J]. ANZ J Surg, 2007, 77(9):738-741.
14. 中華人民共和國衛生部. 醫院感染監測規范[J]. 中華醫院感染學雜志, 2009, 19(11):Ⅰ-Ⅱ.
15. Stotts NA, Whitney JD. Identifying and evaluating wound infection[J]. Home Healthc Nurse, 1999, 17(3):159-164.
16. Granick M, Gameli R. Surgical wound healing and management[M]. New York:Informa Healthcare USA, 2007.
17. 趙嵐, 王平. 外科手術部位感染的危險因素分析[J]. 中華臨床感染病雜志, 2009, 6(2):179-181.
18. 肖漢強, 黃秀良. 外科手術切口感染監測分析與控制[J]. 中華醫院感染學雜志, 2010, 20(2):204-206.
19. Astagneau P, L'Hériteau F, Daniel F, et al. Reducing surgical site infection incidence through a network:results from the French ISO-RAISIN surveillance system[J]. J Hosp Infect, 2009, 72(2):127-134.

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