Surgical site infection: incidence and impact on hospital utilization and treatment costs.
ABSTRACT Surgical site infections (SSIs) are serious operative complications that occur in approximately 2% of surgical procedures and account for some 20% of health care-associated infections.
SSI was identified based on the presence of ICD-9-CM diagnosis code 998.59 in hospital discharge records for 7 categories of surgical procedures: neurological; cardiovascular; colorectal; skin, subcutaneous tissue, and breast; gastrointestinal; orthopedic; and obstetric and gynecologic. Source of data was the 2005 Healthcare Cost and Utilization Project National Inpatient Sample (HCUP NIS). Primary study outcomes were rate of SSI by surgical category and impact of SSI on length of stay and cost. Results were projected to the national level.
Among 723,490 surgical hospitalizations in the sample, 6891 cases of SSI were identified (1%). On average, SSI extended length of stay by 9.7 days while increasing cost by $20,842 per admission. From the national perspective, these cases of SSI were associated with an additional 406,730 hospital-days and hospital costs exceeding $900 million. An additional 91,613 readmissions for treatment of SSI accounted for a further 521,933 days of care at a cost of nearly $700 million.
SSI is associated with a significant economic burden in terms of extended length of stay and increased costs of treatment. Our analysis documented nearly 1 million additional inpatient-days and $1.6 billion in excess costs.
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ABSTRACT: Microbial contamination of the operating theatre (OT) is a major cause of nosocomial infection (NI). The study assessed the level of microbial contamination and determines the antimicrobial resistance of the bacterial isolates. Settle plate's method was used for air sample collection while swab method was used to collect samples from surfaces and other articles in the major OT. Collected samples were transported and microbiologically processed using standard procedures. One hundred and twenty air, 36 article and 12 surface samples were taken for microbiological evaluation. The highest level of microbial contamination was detected in the OT air before proper cleaning-fumigation as compared to after the intervention. Moreover, microbial growth was found on surfaces and semi-critical articles. On the other hand, articles which were sterilized by autoclave showed no microbial growth. The five types of bacteria isolated were coagulase negative Staphyllococci (68; 53.4%), Staphyllococcus aureus (42; 33.1%), Pseudomonas aeruginosa (13; 10.2%), E. coli (2; 1.6%), and Bacillus spp. (2; 1.6%). Methicillin resistance S. aureus (MRSA) account for 7.7% of the S. aureus isolates. The highest resistance was found against penicillin G and ampicillin with a resistance rate of 52.7 and 44.5%, respectively. Multidrug resistance was observed among 23 (36.5%) of the bacterial isolates. In general, the results indicate proper cleaning-fumigation of OT significantly reduced the microbial contamination, and bacterial strains such as coagulase negative Staphylococci, and S. aureus have a greater propensity to cause contamination in OT. In conclusion, there was high level of microbial contamination in the OT, particularly in air and semi-critical articles. However, it has been dramatically reduced through proper cleaning-fumigation of the OT. Therefore, regular microbiological surveillance of the OT is mandatory in reducing microbial contamination. Furthermore, efforts should be made to ensure strict infection control practices in the OT.African journal of microbiology research 04/2015; 9(9):639-642. DOI:10.5897/AJMR2014.7276 · 0.54 Impact Factor
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ABSTRACT: Two-thirds of hindfoot fractures involve the calcaneus. The best treatment for intraarticular fractures is still debated. The goal of treatment has been focussed for years on the anatomical reduction of the articular surface. Open reduction and internal fixation enables the surgeon to view the articular surface directly, but it is associated with a high rate of wound breakdown and infection. Therefore, length, width and angular replacement of the great tuberosity are actually the main parameters to consider when treating this type of fracture. This is a report of our experience of 20 patients treated with a minimally invasive technique of reduction using an inflatable bone tamp filled with tricalcium phosphate, with a mean follow-up of 12.25 months (range 7-26 months). Percutaneous K-wires were used to help reduction and to direct balloon inflation. Surgical goals were restoration of the mechanical stability for earlier full weight-bearing and patient mobilisation. Copyright © 2014. Published by Elsevier Ltd.Injury 10/2014; 45. DOI:10.1016/j.injury.2014.10.027 · 2.46 Impact Factor
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ABSTRACT: The final published version of this work will be posted in Digital Commons@Becker in August 2011.