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García-Arenzana N, Redondo-Bravo L, Espinel-Ruiz MA, Borrego-Prieto P, Ruiz-Carrascoso G, Quintas-Viqueira A, Sanchez-Calles A, Robustillo-Rodela A. Carbapenem-Resistant Enterobacteriaceae Outbreak in a Medical Ward in Spain: Epidemiology, Control Strategy, and Importance of Environmental Disinfection. Microb Drug Resist 2019; 26:54-59. [PMID: 31524566 DOI: 10.1089/mdr.2018.0390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Introduction: Carbapenem-resistant Enterobacteriaceae (CRE) are a growing public health problem. We describe an outbreak by CRE and the measures to control it in a hospitalization unit in Spain. Methods: In June 2015, the system of prevention and control of CRE implemented in the hospital detected an increase in the incidence of patients with CRE in a mixed hospitalization facility (geriatrics, internal medicine, and pneumology), with the appearance of four related patients in 2 weeks, three of them being nosocomial cases. A multidisciplinary group was created and carried out: weekly screenings, general cleaning, four training sessions for personnel, two hand hygiene observation studies and environmental sampling. A higher incidence of new cases was detected in three adjoining rooms, in which environmental decontamination was performed with vaporized hydrogen peroxide. Results: In 5 months, a total of 18 cases were detected, 14 of them were nosocomial. Four different clones of Klebsiella pneumoniae OXA-48 were responsible for 83.3% of the cases. Adherence to hand hygiene increased from 36% to 85% after the training sessions. Seven percent of the environmental samples were positive for CRE in rooms with high incidence, moving to 0% after decontamination with hydrogen peroxide. Three patients died, one of them possibly associated with clinical infection due to CRE. Conclusions: Multidisciplinary information strategies, personnel training, and control of environmental reservoirs are effective to address outbreaks of CRE.
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Affiliation(s)
| | | | | | | | | | | | - Ana Sanchez-Calles
- Preventive Medicine Department, La Paz University Hospital, Madrid, Spain
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2
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Redondo-Bravo L, Gutiérrez-González E, San Juan-Sanz I, Fernández-Jiménez I, Ruiz-Carrascoso G, Gallego-Lombardo S, Sánchez-García L, Elorza-Fernández D, Pellicer-Martínez A, Omeñaca F, Robustillo-Rodela A. Serratia marcescens outbreak in a neonatology unit of a Spanish tertiary hospital: Risk factors and control measures. Am J Infect Control 2019; 47:271-279. [PMID: 30392995 DOI: 10.1016/j.ajic.2018.08.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND We describe the investigation undertaken and the measures adopted to control a Serratia marcescens outbreak in the neonatology unit of La Paz University Hospital in Madrid, Spain. METHODS Weekly rectal and pharyngeal screenings for S marcescens were performed in the neonates starting after detection of the outbreak. Environmental samples and samples from health care workers (HCWs) were obtained for microbiological analysis. An unmatched case-control study was carried out to investigate risk factors for infection/colonization. RESULTS The outbreak began in June 2016 and ended in March 2017, affecting a total of 59 neonates. Twenty-five (42.37%) neonates sustained an infection, most frequently conjunctivitis and sepsis. Multivariate logistic regression identified the following risk factors: parenteral nutrition (odds ratio [OR], 103.4; 95% confidence interval [CI], 11.9-894.8), history of previous radiography (OR, 15.3; 95% CI, 2.4-95.6), and prematurity (OR, 5.65; 95% CI, 1.5-21.8). Various measures were adopted to control the outbreak, such as strict contact precautions, daily multidisciplinary team meetings, cohorting, allocation of dedicated staff, unit disinfection, and partial closure. Hands of HCWs were the main suspected mechanism of transmission, based on the inconclusive results of the environmental investigation and the high number of HCWs and procedures performed in the unit. CONCLUSIONS S marcescens spreads easily in neonatology units, mainly in neonatal intensive care units, and is often difficult to control, requiring a multidisciplinary approach. Strict measures, including cohorting and medical attention by exclusive staff, are often needed to get these outbreaks under control.
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Affiliation(s)
- Lidia Redondo-Bravo
- Department of Preventive Medicine, La Paz University Hospital, Madrid, Spain.
| | | | | | | | | | | | | | | | | | - Félix Omeñaca
- Department of Neonatology, La Paz University Hospital, Madrid, Spain
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3
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González-Rubio R, Parra-Blázquez D, San-Juan-Sanz I, Ruiz-Carrascoso G, Gallego S, Escosa-García L, Robustillo-Rodela A. [Evolution of the incidence of colonized and infected patients by VIM carbapenemase-producing bacteria in a pediatric hospital in Spain]. Rev Esp Quimioter 2019; 32:60-67. [PMID: 30547502 PMCID: PMC6372957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study is to describe the evolution of the incidence of infected and colonized patients with carbapenemase VIM-producing bacteria (CPB-VIM) at a national referral pediatric center in Madrid, Spain, between 2012 and 2015. METHODS Descriptive epidemiological surveillance study. The surveillance system included case detection (screening for BPC colonization in all admitted patients, with periodicity according to the ward) and control measures (contact precautions, identification of previously colonized patients at admission, environmental cleaning, education, supervision of contact precautions, and patient cohort). All hospitalized patients with first positive microbiological sample for CPB-VIM in 2012-2015 were included. Colonized patients were followed through clinical history to evaluate later infection. RESULTS We found 239 colonized and 51 infected patients with CPB-VIM (49.3% women, 47.6% were 5 months old or younger, 52.1% admitted at Intensive Care Unit). Infection and colonization incidence were, respectively, 2.6 and 6.7 cases per one thousand hospitalized patients in 2012, 1.8 and 10.0 in 2014 and 0.3 and 5.0 in 2015. Within these patients, 84.4% shared ward with other patient with previous positive sample. 13.0% (31/239) of colonized patients had a subsequent infection. CONCLUSIONS We have shown data of pediatric patients affected by BPC-VIM, collected from an epidemiological surveillance system that included systematic screening at a national referral center. After an epidemic period, the incidence of cases went down. The surveillance and infection control measures intensification, as well as coordination with involved departments, were key in the handling of the situation.
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Affiliation(s)
| | | | | | | | - Sara Gallego
- Servicio de Medicina Preventiva, Hospital Universitario La Paz, Madrid
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4
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Gutiérrez-González E, Cantero-Escribano JM, Redondo-Bravo L, San Juan-Sanz I, Robustillo-Rodela A, Cendejas-Bueno E. Effect of vaccination, comorbidities and age on mortality and severe disease associated with influenza during the season 2016-2017 in a Spanish tertiary hospital. J Infect Public Health 2019; 12:486-491. [PMID: 30670352 DOI: 10.1016/j.jiph.2018.11.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 08/10/2018] [Accepted: 11/11/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Identifying risk factors for complications or death associated with influenza remains crucial to target preventive interventions. Scores like the Charlson comorbidity index (CCI) may be of help. The aims of this study were to assess the effect of vaccination and comorbidities on severe influenza disease and influenza-related death among hospitalized patients during the season 2016/17; and to evaluate the validity of the CCI to predict death among these patients. METHODS Data from adult patients (≥18 years old) with influenza infection admitted to La Paz University Hospital (LPUH) were recorded during the 2016/17 epidemic. The effect of influenza vaccine to prevent severe influenza or death was evaluated using multivariate logistic regression models. The area under the curve of the CCI and the age-adjusted CCI were compared to assess the predictive effect on mortality. RESULTS A total of 342 adult patients with influenza infection were admitted, of which 83 developed severe influenza and 25 died during hospitalization. There were no differences between patients who survived and those who died concerning the CCI, but the age-adjusted CCI was higher in fatal cases (p-value=0.005). Influenza vaccine had no statistically significant effect on the risk of mortality (p-value=0.162) while age (OR: 1.12, p-value<0.001) and dementia (OR: 3.05, p-value=0.016) proved to be independent predictors for mortality. The seasonal vaccine was found to be protective for severe infection (OR: 0.54, p-value=0.019). The age-adjusted CCI was a better predictor of mortality than the crude CCI. CONCLUSIONS Age and dementia are significant independent risk factors for mortality associated with influenza among hospitalized patients. The age-adjusted CCI seems to be a better predictor of mortality than the crude CCI. Influenza vaccine has shown to be effective in preventing severe influenza in the season 2016/17 among hospitalized patients and should be promoted in population at risk.
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Affiliation(s)
- Enrique Gutiérrez-González
- Unidad Docente de Medicina Preventiva y Salud Pública, Escuela Nacional de Sanidad-Instituto de Salud Carlos III, Madrid, Spain.
| | - José M Cantero-Escribano
- Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
| | - Lidia Redondo-Bravo
- Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
| | - Isabel San Juan-Sanz
- Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
| | - Ana Robustillo-Rodela
- Servicio de Medicina Preventiva Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
| | - Emilio Cendejas-Bueno
- Servicio de Microbiología, Hospital Universitario La Paz-Carlos III-Cantoblanco, Madrid, Spain
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Robustillo-Rodela A, Pérez-Blanco V, Espinel Ruiz MA, Ruiz Carrascoso G, Figueira Iglesias JC, Abad Martín D. Successful control of 2 simultaneous outbreaks of OXA-48 carbapenemase-producing Enterobacteriaceae and multidrug-resistant Acinetobacter baumannii in an intensive care unit. Am J Infect Control 2017; 45:1356-1362. [PMID: 28893449 DOI: 10.1016/j.ajic.2017.07.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/20/2017] [Accepted: 07/20/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND This report describes a double outbreak of OXA-48-producing Enterobacteriaceae (OXA-48-PE) and multidrug-resistant Acinetobacter baumannii (MRAB) in an intensive care unit (ICU) and the effectiveness of measures implemented, including decontamination with vaporized hydrogen peroxide (VHP). METHODS Affected patients were isolated in a confined area and cared for by dedicated personnel. Four percent chlorhexidine soap was used for patient daily hygiene. All patients are subjected to contact precautions. An in-depth cleaning of the ICU was performed with a chlorine solution, followed by decontamination with VHP. Environmental samples were taken before and after the decontamination. RESULTS From July-October 2015, 13 patients were colonized or infected by OXA-48-PE and 18 by MRAB in the ICU. The cumulative incidence of OXA-48-PE and MRAB was 3.48% and 4.81%, respectively. In the period after the intervention, they were 0.8% and 0%, respectively (P < .001). Before the VHP biodecontamination, 4.5% of environmental samples were positive for OXA-48-PE and none for MRAB. After biodecontamination, 1.4% of samples were positive for OXA-48-PE. CONCLUSIONS This study emphasizes the importance of environmental hygiene in the control of outbreaks caused by microorganisms of high environmental impact. The rapid effect after the VHP treatment suggests an influence of this measure in eradication.
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Affiliation(s)
- A Robustillo-Rodela
- Servicio de Medicina Preventiva, Hospital Universitario la Paz-Cantoblanco-Carlos III, Madrid, Spain.
| | - V Pérez-Blanco
- Servicio de Medicina Preventiva, Hospital Universitario la Paz-Cantoblanco-Carlos III, Madrid, Spain
| | - M A Espinel Ruiz
- Servicio de Medicina Preventiva, Hospital Universitario la Paz-Cantoblanco-Carlos III, Madrid, Spain
| | - G Ruiz Carrascoso
- Servicio de Microbiología, Hospital Universitario la Paz-Cantoblanco-Carlos III, Madrid, Spain
| | - J C Figueira Iglesias
- Unidad de Vigilancia Intensiva, Hospital Universitario la Paz-Cantoblanco-Carlos III, Madrid, Spain
| | - D Abad Martín
- Servicio de Medicina Preventiva, Hospital Universitario la Paz-Cantoblanco-Carlos III, Madrid, Spain
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González-Vélez A, Romero-Martín M, Villanueva-Orbaiz R, Díaz-Agero-Pérez C, Robustillo-Rodela A, Monge-Jodra V. The cost of infection in hip arthroplasty: A matched case–control study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016. [DOI: 10.1016/j.recote.2016.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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7
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González-Vélez AE, Romero-Martín M, Villanueva-Orbaiz R, Díaz-Agero-Pérez C, Robustillo-Rodela A, Monge-Jodra V. The cost of infection in hip arthroplasty: a matched case-control study. Rev Esp Cir Ortop Traumatol (Engl Ed) 2016; 60:227-33. [PMID: 27161768 DOI: 10.1016/j.recot.2016.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 01/22/2016] [Accepted: 02/09/2016] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Surgical site infection (SSI) represents 30% of all causes of health care-associated infection (HAI) and is one of the most dreaded complications in surgical patients. We estimated the excess direct costs of SSI using a matched nested case-control study in acute-term care at Ramon y Cajal University Hospital in Spain. MATERIAL AND METHOD Cases were patients who developed a first episode of SSI according to the criteria established by the CDC's National Healthcare Safety Network. Controls were matched to cases in 1:1 ratio taking into account the American Society of Anesthesiologists score, age, sex, surgery date, and principal diagnosis. RESULTS This study found that infection in hip replacement increased direct costs by 134%. Likewise, the excess cost due to the infections caused by methicillin resistant Staphylococcus aureus was 69% higher than the excess cost attributable to infections caused by other microorganisms. CONCLUSIONS SSI after hip replacement continues to be a costly complication from the hospital perspective. Costs due to SSI can be used to prioritise preventive interventions to monitor and control HAI.
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Affiliation(s)
| | - M Romero-Martín
- Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad Complutense de Madrid, Madrid, España
| | - R Villanueva-Orbaiz
- Departamento de Medicina Preventiva, Salud Pública e Historia de la Ciencia, Universidad Complutense de Madrid, Madrid, España
| | | | | | - V Monge-Jodra
- Hospital Universitario Ramón y Cajal, Madrid, España
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San Juan Sanz I, Díaz-Agero-Pérez C, Robustillo-Rodela A, Pita López MJ, Oliva Iñiguez L, Monge-Jodrá V. [Implementation of a post-discharge surgical site infection system in herniorrhaphy and mastectomy procedures]. Enferm Infecc Microbiol Clin 2013; 32:502-6. [PMID: 24054042 DOI: 10.1016/j.eimc.2013.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 06/09/2013] [Accepted: 06/11/2013] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Monitoring surgical site infection (SSI) performed during hospitalization can underestimate its rates due to the shortening in hospital stay. The aim of this study was to determine the actual rates of SSI using a post-discharge monitoring system. METHODS All patients who underwent herniorraphy or mastectomy in the Hospital Universitario Ramón y Cajal from 1 January 2011 to 31 December 2011 were included. SSI data were collected prospectively according to the continuous quality improvement indicators (Indicadores Clinicos de Mejora Continua de la Calidad [INCLIMECC]) monitoring system. Post-discharge follow-up was conducted by telephone survey. RESULTS A total of 409patients were included in the study, of whom 299 underwent a herniorraphy procedure, and 110 underwent a mastectomy procedure. For herniorrhaphy, the SSI rate increased from 6.02% to 7.6% (the post-discharge survey detected 21.7% of SSI). For mastectomy, the SSI rate increased from 1.8% to 3.6% (the post-discharge survey detected 50% of SSI). CONCLUSIONS Post-discharge monitoring showed an increased detection of SSI incidence. Post-discharge monitoring is useful to analyze the real trend of SSI, and evaluate improvement actions. Post-discharge follow-up methods need to standardised.
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Affiliation(s)
- Isabel San Juan Sanz
- Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España.
| | | | - Ana Robustillo-Rodela
- Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España
| | - María José Pita López
- Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España
| | - Lourdes Oliva Iñiguez
- Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España
| | - Vicente Monge-Jodrá
- Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España
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González-Vélez A, Díaz-Agero Pérez C, Robustillo-Rodela A, Monge-Jodrá V. Incidencia y factores asociados a la infección de localización quirúrgica tras artroplastia de cadera. Rev Esp Cir Ortop Traumatol (Engl Ed) 2011. [DOI: 10.1016/j.recot.2011.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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González-Vélez AE, Díaz-Agero-Pérez C, Robustillo-Rodela A, Cornejo-Gutiérrez AM, Pita-López MJ, Oliva-Iñiguez L, Monge-Jodra V. [Factors associated to admission to Intensive Care in patients hospitalized due to pandemic Influenza A/H1N1 2009]. Med Intensiva 2011; 35:463-9. [PMID: 21536346 DOI: 10.1016/j.medin.2011.03.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Revised: 03/08/2011] [Accepted: 03/11/2011] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The present study explores the possible factors related to severe cases of pandemic flu. DESIGN A retrospective cohort study was conducted in patients hospitalized with Influenza A/H1N1 2009 during the pandemic period. SETTING Ramon y Cajal University Hospital (Madrid, Spain). PATIENTS All hospitalized patients with positive RT-PCR (real-time polymerase chain reaction) for Influenza A/H1N1 2009 virus. MAIN VARIABLES The main variables collected were: history of risk factors for severe Influenza, history of immunization, clinical presentation, laboratory tests, chest X-ray report, administration of antiviral treatment, and hospital stay. RESULTS The median age of the 100 cases was 38 years (range 4 months to 80 years). Seventy-seven percent of the patients had at least one risk factor. Asthma was the most common factor among patients younger than 18 years, versus smoking in the older subjects. Antiviral therapy was initiated a median time of three days (range 0 to 18 days) after the onset of illness. Nineteen percent of the patients were admitted to Intensive Care, and 2% died. Metabolic disease and abnormal chest X-ray findings were factors associated to admission to the ICU. CONCLUSION As in other studies, abnormal chest X-ray findings upon admission and metabolic disease were related to poor outcomes of 2009 pandemic Influenza A (H1N1) infection in our patients.
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Affiliation(s)
- A E González-Vélez
- Servicio de Medicina Preventiva, Hospital Universitario Ramón y Cajal, Madrid, España.
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Díaz-Agero C, Pita-López M, Robustillo-Rodela A, Rodríguez-Caravaca G, Martínez-Mondéjar B, Monge-Jodra V. Incidencia de infección nosocomial en cirugía abierta de próstata. Actas Urol Esp 2011. [DOI: 10.4321/s0210-48062011000500003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Díaz-Agero-Pérez C, Pita-López MJ, Robustillo-Rodela A, Figuerola-Tejerina A, Monge-Jodrá V. Evaluación de la infección de herida quirúrgica en 14 hospitales de la Comunidad de Madrid: estudio de incidencia. Enferm Infecc Microbiol Clin 2011; 29:257-62. [DOI: 10.1016/j.eimc.2010.09.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 08/05/2010] [Accepted: 09/02/2010] [Indexed: 12/21/2022]
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Rodríguez-Caravaca G, de las Casas-Cámara G, Pita-López MJ, Robustillo-Rodela A, Díaz-Agero C, Monge-Jodrá V, Fereres J. [Preoperative preparation, antibiotic prophylaxis and surgical wound infection in breast surgery]. Enferm Infecc Microbiol Clin 2011; 29:415-20. [PMID: 21440961 DOI: 10.1016/j.eimc.2011.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Revised: 01/26/2011] [Accepted: 02/01/2011] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The impact of surgical wound infection on public health justifies its surveillance and prevention. Our objectives were to estimate the incidence of surgical wound infection in breast procedures and assess its protocol of antibiotic prophylaxis and preoperative preparation. METHODS Observational multicentre prospective cohort study of incidence of surgical wound infection. Incidence was evaluated, stratified by National Nosocomial Infection Surveillance (NNIS) risk index and we calculated the standardized incidence ratio (SIR). The SIR was compared with Spanish rates and U.S. rates. The compliance and performance of the antibiotic prophylaxis and preoperative preparation protocol were assessed and their influence in the incidence of infection with the relative risk. RESULTS Ten hospitals from the Comunidad de Madrid were included, providing 592 procedures. The cumulative incidence of surgical wound infection was 3.89% (95% CI: 2.3-5.5). The SIR was 1.82 on the Spanish rate and 2.16 on the American. Antibiotic prophylaxis was applied in 97.81% of cases, when indicated. The overall performance of antibiotic prophylaxis was 75%, and 53% for preoperative preparation. No association was found between infection and performance of prophylaxis or preoperative preparation (P>.05). CONCLUSION Our incidence is within those seen in the literature although it is somewhat higher than the national surveillance programs. The performance of prophylaxis antibiotic must be improved, as well as the recording of preoperative preparation data.
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Affiliation(s)
- Gil Rodríguez-Caravaca
- Unidad de Medicina Preventiva, Hospital Universitario de Alcorcón, Departamento de Medicina Preventiva, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
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