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Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017

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Listed:
  • Małgorzata Kołpa

    (State Higher Vocational School in Tarnów, St. Luke’s Provincial Hospital in Tarnów, 33-100 Tarnów, Poland)

  • Marta Wałaszek

    (State Higher Vocational School in Tarnów, St. Luke’s Provincial Hospital in Tarnów, 33-100 Tarnów, Poland)

  • Anna Różańska

    (Department of Microbiology, Faculty of Medicine, Jagiellonian University Collegium Medicum, 31-121 Kraków, Poland)

  • Zdzisław Wolak

    (State Higher Vocational School in Tarnów, St. Luke’s Provincial Hospital in Tarnów, 33-100 Tarnów, Poland)

  • Jadwiga Wójkowska-Mach

    (Department of Microbiology, Faculty of Medicine, Jagiellonian University Collegium Medicum, 31-121 Kraków, Poland)

Abstract

Introduction : The objective of the analysis was to determine the epidemiology of healthcare-associated infections (HAIs) in neurosurgical patients, paying special attention to two time points, 2003 and 2017, in order to evaluate the effectiveness of a surveillance program introduced in 2003 and efforts to reduce infection rates. Materials and methods : Continuous surveillance during 2003–2017 carried out using the HAI-Net methodology allowed us to detect 476 cases of HAIs among 10,332 patients staying in a 42-bed neurosurgery unit. The intervention in this before–after study (2003–2017) comprised standardized HAI surveillance with regular analysis and feedback. Results : The HAI incidence during the whole study was 4.6%. Surgical site infections (SSIs) accounted for 33% of all HAIs with an incidence rate of 1.5%. The remaining infections were pneumonia (1.1%) and bloodstream infections (0.9%). The highest SSI incidence concerned spinal fusion (FUSN, 2.2%), craniotomy (1.9%), and ventricular shunt (5.1%) while the associated total HAI incidence rates were 4.1%, 8.0%, and 18.6%, respectively. A significant reduction was found in HAI incidence between 2003 and 2017 in regard to the most common surgery types: laminectomy (4.5% vs. 0.8%); FUSN (11.8% vs. 0.8%); and craniotomy (10.1% vs. 0.4%). Significant changes were also achieved in selected elements of the unit’s work: pre-hospitalization duration, hospital stay, and surgery length reductions. Simultaneously, the general condition of patients became significantly worse: there was an increase in patients’ age and decreases in their general condition as expressed by ASA scores (The American Society of Anesthesiologists physical status classification system). Conclusions : HAI epidemiology changed substantially during the study period. Among the main types of HAI, SSIs were slightly predominant, but non-surgical HAIs accounted for almost two thirds of all infections; this indicates the need for surveillance of infection types other than SSIs in surgical patients. The implementation of active surveillance based on regular analysis and feedback led to a significant reduction in HAI incidence.

Suggested Citation

  • Małgorzata Kołpa & Marta Wałaszek & Anna Różańska & Zdzisław Wolak & Jadwiga Wójkowska-Mach, 2019. "Epidemiology of Surgical Site Infections and Non-Surgical Infections in Neurosurgical Polish Patients—Substantial Changes in 2003–2017," IJERPH, MDPI, vol. 16(6), pages 1-12, March.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:6:p:911-:d:213697
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    References listed on IDEAS

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    1. Małgorzata Kołpa & Marta Wałaszek & Anna Różańska & Zdzisław Wolak & Jadwiga Wójkowska-Mach, 2018. "Hospital-Wide Surveillance of Healthcare-Associated Infections as a Source of Information about Specific Hospital Needs. A 5-Year Observation in a Multiprofile Provincial Hospital in the South of Pola," IJERPH, MDPI, vol. 15(9), pages 1-10, September.
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    Cited by:

    1. Elżbieta Rafa & Małgorzata Kołpa & Marta Zofia Wałaszek & Adam Domański & Michał Jan Wałaszek & Anna Różańska & Jadwiga Wójkowska-Mach, 2022. "Healthcare-Acquired Infection Surveillance in Neurosurgery Patients, Incidence and Microbiology, Five Years of Experience in Two Polish Units," IJERPH, MDPI, vol. 19(12), pages 1-10, June.

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