Surgical site infection surveillance for neurosurgical procedures: a comparison of passive surveillance by surgeons to active surveillance by infection control professionals

Diane Heipel; Janis F Ober; Michael B Edmond; Gonzalo M L Bearman

doi:10.1016/j.ajic.2006.07.008

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Surgical site infection surveillance for neurosurgical procedures: a comparison of passive surveillance by surgeons to active surveillance by infection control professionals

Journal article

Peer reviewed

Surgical site infection surveillance for neurosurgical procedures: a comparison of passive surveillance by surgeons to active surveillance by infection control professionals

Diane Heipel, Janis F Ober, Michael B Edmond and Gonzalo M L Bearman

American journal of infection control, Vol.35(3), pp.200-202

04/2007

DOI: 10.1016/j.ajic.2006.07.008

PMID: 17433945

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Abstract

Surveillance methods for surgical site infections (SSIs) range from patient self-report to active surveillance by infection control professionals (ICPs). Surgeon questionnaires surveying SSIs are typically suboptimal due to bias, lack of standardized criteria to diagnose infection, and poor response rate. Although concurrent surveillance of SSIs by ICPs at our medical center documented an incidence of 2.2 SSIs per 100 procedures, the neurosurgeons perceived a much higher rate of SSIs. The neurosurgeons provided a list of patients they had clinically identified with SSIs over a 7 month period. This list was compared with a line listing of SSIs independently identified by ICPs via concurrent surveillance utilizing the Centers for Disease Control and Prevention (CDC) definitions. A total of 766 procedures were performed. Active surveillance by ICPs detected 17 infections (2.2/100 procedures). Of the 14 cases identified by the neurosurgeons, 3 did not meet the CDC definition of a nosocomial infection. The ICPs identified 6 SSIs not documented by the neurosurgeons. Compared to active surveillance by ICPs, the sensitivity and specificity of the neurosurgeon's identification of SSIs was 64% and 99.6%, respectively. The positive predictive value was 78.6% and the negative predictive value was 99.2%. An active surveillance program is necessary for accurate identification of SSIs. The primary problem with passive surveillance by surgeons is failure to capture cases; surgeons missed 36% of cases compared to active surveillance by ICPs.

Neurosurgical Procedures - adverse effects

Mandatory Reporting

Surgical Wound Infection - epidemiology

Cross Infection - prevention & control

Physicians

Humans

Hospitals, Teaching

Neurosurgery - manpower

Infection Control Practitioners

Neurosurgical Procedures - statistics & numerical data

Sentinel Surveillance

Infection Control - statistics & numerical data

Details

Title: Subtitle: Surgical site infection surveillance for neurosurgical procedures: a comparison of passive surveillance by surgeons to active surveillance by infection control professionals
Creators: Diane Heipel - Virginia Commonwealth University Medical Center, Richmond, Virginia 23298-0019, USA
Janis F Ober
Michael B Edmond
Gonzalo M L Bearman
Resource Type: Journal article
Publication Details: American journal of infection control, Vol.35(3), pp.200-202
Publisher: United States
DOI: 10.1016/j.ajic.2006.07.008
PMID: 17433945
ISSN: 0196-6553
eISSN: 1527-3296
Language: English
Date published: 04/2007
Academic Unit: Infectious Diseases; Internal Medicine
Record Identifier: 9983905519102771

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