Enhanced identification of postoperative infections among inpatients

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

doi:10.3201/eid1011.040572

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Enhanced identification of postoperative infections among inpatients

Journal article

Open access

Peer reviewed

Enhanced identification of postoperative infections among inpatients

Deborah S Yokoe, Gary A Noskin, Susan M Cunnigham, Gianna Zuccotti, Theresa Plaskett, Victoria J Fraser, Margaret A Olsen, Jerome I Tokars, Steven Solomon, Trish M Perl, …

Emerging infectious diseases, Vol.10(11), pp.1924-1930

11/2004

DOI: 10.3201/eid1011.040572

PMCID: PMC3329006

PMID: 15550201

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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.

Cesarean Section - adverse effects

Cross Infection - etiology

Humans

Patient Discharge

Surgical Wound Infection - etiology

Cross Infection - drug therapy

Anti-Bacterial Agents - therapeutic use

Coronary Artery Bypass - adverse effects

Inpatients

Mammaplasty - adverse effects

Surgical Wound Infection - drug therapy

Surgical Wound Infection - diagnosis

Cross Infection - diagnosis

Population Surveillance - methods

Details

Title: Subtitle: Enhanced identification of postoperative infections among inpatients
Creators: Deborah S Yokoe - Brigham and Women's Hospital, Boston, Massachusetts, USA. deborah.yokoe@channing.harvard.edu
Gary A Noskin
Susan M Cunnigham
Gianna Zuccotti
Theresa Plaskett
Victoria J Fraser
Margaret A Olsen
Jerome I Tokars
Steven Solomon
Trish M Perl
Sara E Cosgrove
Richard S Tilson
Maurice Greenbaum
David C Hooper
Kenneth E Sands
John Tully
Loreen a Herwaldt
Daniel J Diekema
Edward S Wong
Michael Climo
Richard Platt
Resource Type: Journal article
Publication Details: Emerging infectious diseases, Vol.10(11), pp.1924-1930
DOI: 10.3201/eid1011.040572
PMID: 15550201
PMCID: PMC3329006
NLM abbreviation: Emerg Infect Dis
ISSN: 1080-6040
eISSN: 1080-6059
Publisher: United States
Grant note: UR8CCU-715087 / ODCDC CDC HHS UR8CCU-115079 / ODCDC CDC HHS URCCU-315092 / CCR NIH HHS URCCU-315346 / CCR NIH HHS UR8CCU-215090 / ODCDC CDC HHS UR8CCU-715091 / ODCDC CDC HHS UR8CCU-515081 / ODCDC CDC HHS
Language: English
Date published: 11/2004
Academic Unit: Infectious Diseases; Epidemiology; Pathology; Internal Medicine
Record Identifier: 9983986371202771

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