H J Choi1, L Adiyani2, J Sung2, J Y Choi3, H B Kim4, Y K Kim5, Y G Kwak6, H Yoo7, Sang-Oh Lee8, S H Han9, S R Kim10, T H Kim11, H M Lee12, H K Chun13, J-S Kim14, J D Yoo15, H-S Koo16, E H Cho16, K W Lee17. 1. Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, South Korea. Electronic address: heechoi@ewha.ac.kr. 2. Department of Epidemiology and Institute of Environment and Health, Seoul National University, Seoul, South Korea. 3. Department of Internal Medicine and AIDS Research Institute, Yonsei University College of Medicine, Seoul, South Korea. 4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea. 5. Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea. 6. Department of Internal Medicine, Inje University Ilsan Paik Hospital, Seoul, South Korea. 7. Infection Control Office, Inje University Sanggye Paik Hospital, Seoul, South Korea. 8. Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. 9. Department of Infection Prevention and Control, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea. 10. Infection Control Office, Korea University Guro Hospital, Seoul, South Korea. 11. Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, South Korea. 12. Department of Laboratory Medicine, Kwandong University College of Medicine, Gangneung, South Korea. 13. Department of Infection Control, Kyunghee University Hospital, Seoul, South Korea. 14. Department of Laboratory Medicine, Hallym University College of Medicine, Seoul, South Korea. 15. Department of Orthopedic Surgery, Ewha Woman's University School of Medicine, Seoul, South Korea. 16. Division of Infectious Disease Control, Korean Centers for Disease Control and Prevention, Osong, South Korea. 17. Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Wonju, South Korea.
Abstract
BACKGROUND: Surveillance of healthcare-associated infection has been associated with a reduction in surgical site infection (SSI). AIM: To evaluate the Korean Nosocomial Infection Surveillance System (KONIS) in order to assess its effects on SSI since it was introduced. METHODS: SSI data after gastrectomy, total hip arthroplasty (THA), and total knee arthroplasty (TKA) between 2008 and 2012 were analysed. The pooled incidence of SSI was calculated for each year; the same analyses were also conducted from hospitals that had participated in KONIS for at least three consecutive years. Standardized SSI rates for each year were calculated by adjusting for SSI risk factors. SSI trends were analysed using the Cochran-Armitage test. FINDINGS: The SSI rate following gastrectomy was 3.12% (522/16,918). There was a significant trend of decreased crude SSI rates over five years. This trend was also evident in analysis of hospitals that had participated for more than three years. The SSI rate for THA was 2.05% (157/7656), which decreased significantly from 2008 to 2012. The risk factors for SSI after THA included the National Nosocomial Infections Surveillance risk index, trauma, reoperation, and age (60-69 years). The SSI rate for TKA was 1.90% (152/7648), which also decreased significantly during a period of five years. However, the risk-adjusted analysis of SSI did not show a significant decrease for all surgical procedures. CONCLUSION: The SSI incidence of gastrectomy and prosthetic joint replacement declined over five years as a result of active surveillance by KONIS.
BACKGROUND: Surveillance of healthcare-associated infection has been associated with a reduction in surgical site infection (SSI). AIM: To evaluate the Korean Nosocomial Infection Surveillance System (KONIS) in order to assess its effects on SSI since it was introduced. METHODS: SSI data after gastrectomy, total hip arthroplasty (THA), and total knee arthroplasty (TKA) between 2008 and 2012 were analysed. The pooled incidence of SSI was calculated for each year; the same analyses were also conducted from hospitals that had participated in KONIS for at least three consecutive years. Standardized SSI rates for each year were calculated by adjusting for SSI risk factors. SSI trends were analysed using the Cochran-Armitage test. FINDINGS: The SSI rate following gastrectomy was 3.12% (522/16,918). There was a significant trend of decreased crude SSI rates over five years. This trend was also evident in analysis of hospitals that had participated for more than three years. The SSI rate for THA was 2.05% (157/7656), which decreased significantly from 2008 to 2012. The risk factors for SSI after THA included the National Nosocomial Infections Surveillance risk index, trauma, reoperation, and age (60-69 years). The SSI rate for TKA was 1.90% (152/7648), which also decreased significantly during a period of five years. However, the risk-adjusted analysis of SSI did not show a significant decrease for all surgical procedures. CONCLUSION: The SSI incidence of gastrectomy and prosthetic joint replacement declined over five years as a result of active surveillance by KONIS.