Surgical site infection after small bowel surgery for seven consecutive years trend analysis of standardized infection ratios_West China Medical Journal

Authors：

 LIU Ronghui , LI Gaochun , YI Heping , ZHANG Changfeng , FENG Lin

1. The First College of Clinical Medical Science, China Three Gorges University; Department of Infection Management, Yichang Central People’s Hospital, Yichang, Hubei 443003, P. R. China;

Corresponding author：

LIU Ronghui, Email: 289846631@qq.com

Keywords：

Small bowel surgery; surgical site infection; standardized infection ratio; analysis of trends

DOI：

10.7507/1002-0179.202401053

Video：

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Objective To analyze the trend of standardized infection ratio (SIR) of surgical site infection (SSI) in small bowel surgery, objectively evaluate the effect of infection control, and provide evidence-based strategies for SSI prevention. Methods According to Centers for Disease Control and Prevention (CDC) / National Healthcare Safety Network (NHSN) surveillance definitions for specific types of infections and the monitoring methods of SSI events published by NHSN, the SSI and related risk factors of adult inpatients undergoing small bowel surgery in Yichang Central People’s Hospital between January 1, 2016 and December 31, 2022 were prospectively monitored. The inpatients undergoing small bowel surgery that meets the definition of International Classification of Diseases, 10th Revision Clinical Modifications/Procedure Coding System (ICD-10-CM/PCS), a multivariate binary logistic regression model was used to calculate the predicted infections in each year, the model included the risk factors for small bowel surgery in NHSN Complex Admission/Readmission (A/R) SSI Model with 7 years of surveillance data as the baseline. The SIR was calculated by dividing the number of observed SSI by the number of predicted SSI in each year. The Mid-P method was used to test the difference of SIR compared to the previous year, and the linear regression model was used to analyze the trend of SIR. Results A total of 2 436 patients were included, with 48 cases of deep incision infection and 49 cases of organ/cavity infection, and the overall incidence rate of infection was 4.0%. From 2016 to 2022, there were 151, 244, 222, 260, 320, 408, and 831 patients who underwent small bowel surgery, respectively. The Mid-P test showed that there was a significant difference in SIR from 2016 to 2019 (P<0.05), and there was an increase in 2018 compared with 2017. There was no significant difference in SIR compared to the previous year from 2019 to 2022 (P>0.05), and there was no significant difference in the trend of SIR of SSI (P=0.065). Conclusions From January 1, 2017, to December 31, 2022, advances have been made in SSI control practices of small bowel surgery in six consecutive years, except for 2018, but there was no annual downward trend from 2020 to 2022. The use of SIR provides a new approach for evaluating the quality of infection control.

Citation： LIU Ronghui, LI Gaochun, YI Heping, ZHANG Changfeng, FENG Lin. Surgical site infection after small bowel surgery for seven consecutive years trend analysis of standardized infection ratios. West China Medical Journal, 2024, 39(3): 378-382. doi: 10.7507/1002-0179.202401053 Copy

1.	Magill SS, O’Leary E, Janelle SJ, et al. Changes in prevalence of health care-associated infections in U. S. hospitals. N Engl J Med, 2018, 379(18): 1732-1744.
2.	Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP). 2022 national and state healthcare-associated infections progress report. Centers for Disease Control and Prevention, 2023.
3.	Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med, 2013, 173(22): 2039-2046.
4.	National Healthcare Safety Network . Surgical Site Infection (SSI) Event//National Healthcare Safety Network (NHSN) Patient safety component manual. Centers for Disease Control and Prevention, 2024.
5.	Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Centers for disease control and prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control, 1999, 27(2): 97-132.
6.	Jarvis WR. Benchmarking for prevention: the Centers for Disease Control and Prevention’s National Nosocomial Infections Surveillance (NNIS) system experience. Infection, 2003(Suppl 2): 44-48.
7.	Mu Y, Edwards JR, Horan TC, et al. Improving risk-adjusted measures of surgical site infection for the national healthcare safety network. Infect Control Hosp Epidemiol, 2011, 32(10): 970-986.
8.	The NHSN standardized infection ratio (SIR). Centers for Disease Control and Prevention, 2022: 14-48.
9.	ICD-10-PCS Procedure Code Mapping to NHSN Operative Procedure Codes-January. Centers for Disease Control and Prevention, 2023.
10.	魏倩, 孙木. ICD-10-PCS 手术分类系统及临床应用策略探讨. 中国卫生质量管理, 2022, 29(11): 34-38.
11.	Talbot TR, Bratzler DW, Carrico RM, et al. Healthcare infection control practices advisory committee. Public reporting of health care-associated surveillance data: recommendations from the healthcare infection control practices advisory committee. Ann Intern Med, 2013, 159(9): 631-635.
12.	薄天慧, 陈勇, 韩黎, 等. 中美医院感染诊断标准在某医院感染现患率调查中应用对比分析. 中国消毒学杂志, 2019, 36(5): 374-376.
13.	National Quality Forum. National voluntary consensus standards for the reporting of healthcare-associated infections data. National Quality Forum, 2008.
14.	方积乾. 卫生统计学. 7 版. 北京: 人民卫生出版社, 2012: 46.
15.	刘小燕, 李寅环, 冼翠尧, 等. 医院感染风险评估模型的建立与应用. 中华医院感染学杂志, 2017, 27(17): 4031-4033.
16.	国瑀辰, 孙蕊, 吴斌, 等. 基于单中心数据库的结肠癌术后手术部位感染危险因素分析. 中华胃肠外科杂志, 2022, 25(3): 242-249.
17.	Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP). 2021 national and state healthcare-associated infections progress report. Centers for Disease Control and Prevention, 2022.
18.	Lastinger LM, Alvarez CR, Kofman A, et al. Continued increases in the incidence of healthcare-associated infection (HAI) during the second year of the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol, 2023, 44(6): 997-1001.
19.	Weiner-Lastinger LM, Pattabiraman V, Konnor RY, et al. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: a summary of data reported to the National Healthcare Safety Network. Infect Control Hosp Epidemiol, 2022, 43(1): 12-25.
20.	Fleisher LA, Schreiber M, Cardo D, et al. Health care safety during the pandemic and beyond - building a system that ensures resilience. N Engl J Med, 2022, 386(7): 609-611.

1. Magill SS, O’Leary E, Janelle SJ, et al. Changes in prevalence of health care-associated infections in U. S. hospitals. N Engl J Med, 2018, 379(18): 1732-1744.
2. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP). 2022 national and state healthcare-associated infections progress report. Centers for Disease Control and Prevention, 2023.
3. Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med, 2013, 173(22): 2039-2046.
4. National Healthcare Safety Network . Surgical Site Infection (SSI) Event//National Healthcare Safety Network (NHSN) Patient safety component manual. Centers for Disease Control and Prevention, 2024.
5. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Centers for disease control and prevention (CDC) hospital infection control practices advisory committee. Am J Infect Control, 1999, 27(2): 97-132.
6. Jarvis WR. Benchmarking for prevention: the Centers for Disease Control and Prevention’s National Nosocomial Infections Surveillance (NNIS) system experience. Infection, 2003(Suppl 2): 44-48.
7. Mu Y, Edwards JR, Horan TC, et al. Improving risk-adjusted measures of surgical site infection for the national healthcare safety network. Infect Control Hosp Epidemiol, 2011, 32(10): 970-986.
8. The NHSN standardized infection ratio (SIR). Centers for Disease Control and Prevention, 2022: 14-48.
9. ICD-10-PCS Procedure Code Mapping to NHSN Operative Procedure Codes-January. Centers for Disease Control and Prevention, 2023.
10. 魏倩, 孙木. ICD-10-PCS 手术分类系统及临床应用策略探讨. 中国卫生质量管理, 2022, 29(11): 34-38.
11. Talbot TR, Bratzler DW, Carrico RM, et al. Healthcare infection control practices advisory committee. Public reporting of health care-associated surveillance data: recommendations from the healthcare infection control practices advisory committee. Ann Intern Med, 2013, 159(9): 631-635.
12. 薄天慧, 陈勇, 韩黎, 等. 中美医院感染诊断标准在某医院感染现患率调查中应用对比分析. 中国消毒学杂志, 2019, 36(5): 374-376.
13. National Quality Forum. National voluntary consensus standards for the reporting of healthcare-associated infections data. National Quality Forum, 2008.
14. 方积乾. 卫生统计学. 7 版. 北京: 人民卫生出版社, 2012: 46.
15. 刘小燕, 李寅环, 冼翠尧, 等. 医院感染风险评估模型的建立与应用. 中华医院感染学杂志, 2017, 27(17): 4031-4033.
16. 国瑀辰, 孙蕊, 吴斌, 等. 基于单中心数据库的结肠癌术后手术部位感染危险因素分析. 中华胃肠外科杂志, 2022, 25(3): 242-249.
17. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality Promotion (DHQP). 2021 national and state healthcare-associated infections progress report. Centers for Disease Control and Prevention, 2022.
18. Lastinger LM, Alvarez CR, Kofman A, et al. Continued increases in the incidence of healthcare-associated infection (HAI) during the second year of the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol, 2023, 44(6): 997-1001.
19. Weiner-Lastinger LM, Pattabiraman V, Konnor RY, et al. The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: a summary of data reported to the National Healthcare Safety Network. Infect Control Hosp Epidemiol, 2022, 43(1): 12-25.
20. Fleisher LA, Schreiber M, Cardo D, et al. Health care safety during the pandemic and beyond - building a system that ensures resilience. N Engl J Med, 2022, 386(7): 609-611.

West China Medical Journal

Surgical site infection after small bowel surgery for seven consecutive years trend analysis of standardized infection ratios

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