RESUMO
Introducción y objetivos: Las infecciones relacionadas con la asistencia sanitaria son una causa importante de mortalidad y morbilidad entre los pacientes. Una de las más frecuentes es la infección de localización quirúrgica (ILQ). Los objetivos del estudio eran conocer las tasas de ILQ y valorar la aplicación de los protocolos de preparación prequirúrgica y profilaxis antibiótica preoperatoria establecidos en 14 hospitales públicos de la Comunidad de Madrid. Material y métodos: Estudio prospectivo observacional multicéntrico que incluye a todos los pacientes intervenidos quirúrgicamente en los servicios sometidos a vigilancia e ingresados durante más de 48 h, entre el 1 de enero y el 31 de diciembre de 2009. Fueron vigilados desde el ingreso hasta el alta. Resultados: La ILQ fue la infección nosocomial más frecuente (superficial = 1,7%, profunda = 2%; órgano espacio= 1,7%). Se muestran las tasas de ILQ por procedimiento quirúrgico e índice de riesgo National Nosocomial Infection Surveillance System, así como otros indicadores de calidad, como estancia hospitalaria,profilaxis antibiótica, mortalidad, reingresos por infección o complicación y tasa de reintervenciones quirúrgicas. Discusión: Los resultados obtenidos en este estudio multicéntrico no sólo pueden servir como referenciaa otros hospitales públicos, sino que también son comparables con otros sistemas de vigilancia internacionales. La vigilancia y el control de las infecciones asociadas a la asistencia sanitaria deben ser un aspecto clave en los programas de calidad asistencial y seguridad del paciente (AU)
Background and objectives: Health care-associated infections (HAIs) occur frequently in hospitals and have severe consequences, with surgical site infection (SSI) being one of the most commonly reported. The aim of this study was to determine SSI rates and to assess the application of presurgical preparation and antimicrobial prophylaxis protocols in 14 public hospitals of the region of Madrid. Material and methods: Multi-centre prospective surveillance study. All patients who underwent a surgical procedure from January 1 2009, to December 31, 2009 with a hospital stay of more than 48 hours, were monitored from the time of surgery until hospital discharge. Results: SSI was the most frequent HAI (superficial incisional SSI = 1.7%; deep incisional SSI = 2%; organ space SSI = 1.7%). SSI rates are provided by operative procedure and NNIS risk index category. Further quality indicators reported are surgical complications, length of stay, antimicrobial prophylaxis, mortality, readmission due to infection or other complications and revision surgery. Conclusions: The results obtained in this multicentre study can be used as a reference for other public hospitals, and allow comparisons with other international surveillance systems. Surveillance and control of HAIs must be a key aspect in patient safety and quality healthcare programs (AU)
Assuntos
Humanos , Infecção da Ferida Cirúrgica/epidemiologia , Antibioticoprofilaxia , Infecção da Ferida Cirúrgica/terapia , Complicações Pós-Operatórias/terapia , Monitoramento Epidemiológico , Infecção Hospitalar/epidemiologia , Estudos de CoortesRESUMO
BACKGROUND AND OBJECTIVES: Health care-associated infections (HAIs) occur frequently in hospitals and have severe consequences, with surgical site infection (SSI) being one of the most commonly reported. The aim of this study was to determine SSI rates and to asses the application of presurgical preparation and antimicrobial prophylaxis protocols in 14 public hospitals of the region of Madrid. MATERIAL AND METHODS: Multi-centre prospective surveillance study. All patients who underwent a surgical procedure from January 1 2009, to December 31, 2009 with a hospital stay of more than 48 hours, were monitored from the time of surgery until hospital discharge. RESULTS: SSI was the most frequent HAI (superficial incisional SSI=1.7%; deep incisional SSI=2%; organ-space SSI=1.7%). SSI rates are provided by operative procedure and NNIS risk index category. Further quality indicators reported are surgical complications, length of stay, antimicrobial prophylaxis, mortality, readmission due to infection or other complications and revision surgery. CONCLUSIONS: The results obtained in this multicentre study can be used as a reference for other public hospitals, and allow comparisons with other international surveillance systems. Surveillance and control of HAIs must be a key aspect in patient safety and quality healthcare programs.
