Back to Search
Start Over
Surgical site infection reporting: more than meets the agar
- Source :
- Journal of Pediatric Surgery. 52:156-160
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- Surgical site infection (SSI) rate in pediatric appendicitis is a commonly used hospital quality metric. We hypothesized that surveillance of organ-space SSI (OSI) using cultures alone would fail to capture many clinically-important events.A prospective, multidisciplinary surveillance program recorded 30-day SSI and hospital length of stay (LOS) for patients18years undergoing appendectomy for perforated appendicitis from 2012 to 2015. Standardized treatment pathways were utilized, and OSI was identified by imaging and/or bacterial cultures.Four hundred ten appendectomies for perforated appendicitis were performed, and a total of 84 OSIs (20.5%) were diagnosed with imaging. Positive cultures were obtained for 39 (46%) OSIs, whereas 45 (54%) had imaging only. Compared to the mean LOS for patients without OSI (5.2±2.9days), LOS for patients with OSI and positive cultures (13.7±5.4days) or with OSI without cultures (10.4±3.7days) was significantly longer (both p0.001). The OSI rate identified by positive cultures alone was 9.5%, whereas the clinically-relevant OSI rate was 20.5%.Using positive cultures alone to capture OSI would have identified less than half of clinically-important infections. Utilizing clinically-relevant SSI is an appropriate metric for comparing hospital quality but requires agreed upon standards for diagnosis and reporting.II.Diagnostic study.
- Subjects :
- Male
Microbiological Techniques
medicine.medical_specialty
Hospital quality
Length of hospitalization
030230 surgery
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Internal medicine
medicine
Appendectomy
Humans
Surgical Wound Infection
Pediatric appendicitis
Prospective Studies
Child
Perforated Appendicitis
business.industry
General Medicine
Length of Stay
Appendicitis
medicine.disease
Texas
Surgery
Agar
Intestinal Perforation
030220 oncology & carcinogenesis
Pediatrics, Perinatology and Child Health
Female
business
Surgical site infection
Subjects
Details
- ISSN :
- 00223468
- Volume :
- 52
- Database :
- OpenAIRE
- Journal :
- Journal of Pediatric Surgery
- Accession number :
- edsair.doi.dedup.....f3dad0fc74a3423f6469eb216ff5f988