497. Itís Time to Change our Focus: Surgical Site Infections (SSI) Account for the Greatest Proportion of Hospital-Acquired Infections (HAIs)
Session: Poster Abstract Session: Surgical Site Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C

Background: †† The urinary tract is often cited as the most common site of hospital acquired infections (HAIs), but these data are outdated.† Information regarding the current relative burden of specific types of HAIs is needed to help prioritize areas for research and innovation within the field of infection prevention.†

Methods: †† We performed a retrospective cohort study using HAI surveillance data from 15 community hospitals (median 186 beds, range 50-457 beds) participating in the Duke Infection Control Outreach Network (DICON) that had contributed complete hospital-wide and surgical surveillance data from January 1, 2010 Ė June 30, 2012.† All adult and pediatric cases of central-line associated bloodstream infection (CLABSI), catheter-associated urinary tract infection (CAUTI), ventilator-associated pneumonia (VAP), and hospital-onset healthcare facility associated C. difficile infection (HO-HCFA CDI) identified during the study period were included in the analysis.† All SSI following surgeries performed during the study period were included if they either occurred within 30 days of a surgery not involving implanted material or occurred within 90 days of a surgery involving implanted material.

Results: † The 30-month study period included 100,449 surgeries, 135,716 ICU patient days, and 1,596,277 non-ICU patient days.† A total of 2,345 HAIs were identified.† SSIs were the most common HAI overall (n=822, 38%), Figure 1.† The overall prevalence rate of SSI in our cohort was 0.82 infections/100 surgeries.†† When the data were analyzed by individual hospital, SSIs were the most frequent HAI for 12 (80%) hospitals. The median percentage of HAIs due to SSIs at each hospital was 43% (range 16-64%).† The proportion of HAIs due to SSIs was not related to surgical volume or the ratio between surgical and inpatient volume at individual hospitals.†

Conclusion: † SSIs are now the most frequently observed HAI in our large network of community hospitals, despite an overall low rate of SSI.† Collectively, the infection prevention community has made substantial and important progress in reducing HAIs due to CLABSI and CAUTI in the last decade.† It is time to shift our focus to finding effective and novel methods to prevent SSI.

Sarah S. Lewis, MD1,2, Rebekah W. Moehring, MD, MPH2,3, Luke F. Chen, MBBS, MPH, CIC, FRACP1,2, Daniel J. Sexton, MD, FIDSA1,2 and Deverick J. Anderson, MD, MPH2,3, (1)Duke University Medical Center, Durham, NC, (2)Duke Infection Control Outreach Network, Durham, NC, (3)Division of Infectious Diseases, Duke University Medical Center, Durham, NC


S. S. Lewis, None

R. W. Moehring, None

L. F. Chen, None

D. J. Sexton, None

D. J. Anderson, None

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