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

Małgorzata Kołpa, Marta Wałaszek, Anna Różańska, Zdzisław Wolak and Jadwiga Wójkowska-Mach
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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

IJERPH, 2019, vol. 16, issue 6, 1-12

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.

Keywords: neurosurgery; surgical site infections; spinal surgery; craniotomy; laminectomy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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