Evaluation of routinely reported surgical site infections against microbiological culture results: a tool to identify patient groups where diagnosis and treatment may be improvedReportar como inadecuado




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BMC Infectious Diseases

, 9:176

First Online: 10 November 2009Received: 14 April 2009Accepted: 10 November 2009

Abstract

BackgroundSurgeons may improve their decision making by assessing the extent to which their initial clinical diagnosis of a surgical site infection SSI was supported by culture results. Aim of the present study was to evaluate routinely reported SSI by surgeons against microbiological culture results, to identify patient groups with lower agreement where decision making may be improved.

Methods701 admissions with SSI were reported by surgeons in a university medical centre in the period 1997-2005, which were retrospectively checked for microbiological culture results. Reporting a SSI was conditional on treatment being given e.g. antibiotics and was classified by severity. To identify specific patient groups, patients were classified according to the surgery group of the first operation during admission e.g. trauma.

ResultsOf all reported SSI, 523 74.6% had a positive culture result, 102 14.6% a negative culture result and 76 10.8% were classified as unknown culture result due to no culture taken. Given a known culture result, reported SSI with positive culture results less often concerned trauma patients 16% versus 26%, X = 4.99 p = 0.03 and less severe SSI 49% versus 85%, X = 10.11 p < 0.01 suggesting that a more conservative approach may be warranted in these patients. The trauma surgeons themselves perceived to have become too liberal in administering antibiotics and reporting SSI.

ConclusionRoutine reporting of SSI was mostly supported by culture results. However, this support was less often found in trauma patients and less severe SSI, thereby giving surgeons feedback that diagnosis and treatment may be improved in these cases.

AbbreviationsSSISurgical Site Infection

ICUIntensive Care Unit

CDC NNISCenters for Disease Control and prevention National Nosocomial Infection Survey

LUMCLeiden University Medical Centre

NINSSNosocomial Infection National Surveillance Service.

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Autor: Marco Krukerink - Job Kievit - Perla J Marang-van de Mheen

Fuente: https://link.springer.com/







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