Enhanced identification of postoperative infections among inpatients

Deborah S. Yokoe, Gary A. Noskin, Susan M. Cunningham, Gianna Zuccotti, Theresa Plaskett, Victoria J. Fraser, Margaret A. Olsen, Jerome I. Tokars, Steven Solomon, Trish M. Perl, Sara E. Cosgrove, Richard S. Tilson, Maurice Greenbaum, David C. Hooper, Kenneth E. Sands, John Tully, Loreen A. Herwaldt, Daniel J. Diekema, Edward S. Wong, Michael ClimoRichard Platt

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

We evaluated antimicrobial exposure, discharge diagnoses, or both to identify surgical site infections (SSI). This retrospective cohort study in 13 hospitals involved weighted, random samples of records from 8,739 coronary artery bypass graft (CABG) procedures, 7,399 cesarean deliveries, and 6,175 breast procedures. We compared routine surveillance to detection through inpatient antimicrobial exposure (≥9 days for CABG, ≥2 days for cesareans, and ≥6 days for breast procedures), discharge diagnoses, or both. Together, all methods identified SSI after 7.4% of CABG, 5.0% of cesareans, and 2.0% of breast procedures. Antimicrobial exposure had the highest sensitivity, 88%-91%, compared with routine surveillance, 38%-64%. Diagnosis codes improved sensitivity of detection of antimicrobial exposure after cesareans. Record review confirmed SSI after 31% to 38% of procedures that met antimicrobial surveillance criteria. Sufficient antimicrobial exposure days, together with diagnosis codes for cesareans, identified more postoperative SSI than routine surveillance methods. This screening method was efficient, readily standardized, and suitable for most hospitals.

Original languageEnglish (US)
Pages (from-to)1924-1930
Number of pages7
JournalEmerging Infectious Diseases
Volume10
Issue number11
StatePublished - Nov 1 2004

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Inpatients
Surgical Wound Infection
Infection
Coronary Artery Bypass
Breast
Transplants
Cohort Studies
Retrospective Studies

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

Cite this

Yokoe, D. S., Noskin, G. A., Cunningham, S. M., Zuccotti, G., Plaskett, T., Fraser, V. J., ... Platt, R. (2004). Enhanced identification of postoperative infections among inpatients. Emerging Infectious Diseases, 10(11), 1924-1930.

Enhanced identification of postoperative infections among inpatients. / Yokoe, Deborah S.; Noskin, Gary A.; Cunningham, Susan M.; Zuccotti, Gianna; Plaskett, Theresa; Fraser, Victoria J.; Olsen, Margaret A.; Tokars, Jerome I.; Solomon, Steven; Perl, Trish M.; Cosgrove, Sara E.; Tilson, Richard S.; Greenbaum, Maurice; Hooper, David C.; Sands, Kenneth E.; Tully, John; Herwaldt, Loreen A.; Diekema, Daniel J.; Wong, Edward S.; Climo, Michael; Platt, Richard.

In: Emerging Infectious Diseases, Vol. 10, No. 11, 01.11.2004, p. 1924-1930.

Research output: Contribution to journalArticle

Yokoe, DS, Noskin, GA, Cunningham, SM, Zuccotti, G, Plaskett, T, Fraser, VJ, Olsen, MA, Tokars, JI, Solomon, S, Perl, TM, Cosgrove, SE, Tilson, RS, Greenbaum, M, Hooper, DC, Sands, KE, Tully, J, Herwaldt, LA, Diekema, DJ, Wong, ES, Climo, M & Platt, R 2004, 'Enhanced identification of postoperative infections among inpatients', Emerging Infectious Diseases, vol. 10, no. 11, pp. 1924-1930.
Yokoe DS, Noskin GA, Cunningham SM, Zuccotti G, Plaskett T, Fraser VJ et al. Enhanced identification of postoperative infections among inpatients. Emerging Infectious Diseases. 2004 Nov 1;10(11):1924-1930.
Yokoe, Deborah S. ; Noskin, Gary A. ; Cunningham, Susan M. ; Zuccotti, Gianna ; Plaskett, Theresa ; Fraser, Victoria J. ; Olsen, Margaret A. ; Tokars, Jerome I. ; Solomon, Steven ; Perl, Trish M. ; Cosgrove, Sara E. ; Tilson, Richard S. ; Greenbaum, Maurice ; Hooper, David C. ; Sands, Kenneth E. ; Tully, John ; Herwaldt, Loreen A. ; Diekema, Daniel J. ; Wong, Edward S. ; Climo, Michael ; Platt, Richard. / Enhanced identification of postoperative infections among inpatients. In: Emerging Infectious Diseases. 2004 ; Vol. 10, No. 11. pp. 1924-1930.
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