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Impact of surgical site infection surveillance in a neurosurgical unit
S Buffet-Bataillon1, C Haegelen, L Riffaud
1Unité d'Hygiène Hospitalière, Pôle Microorganismes, CHU Pontchaillou, Rennes, France. sylvie.buffet-bataillon@chu-rennes.fr
Abstract:
This article describes a two-year surveillance of neurosurgical site infections and an outbreak of infections in deep brain stimulation (DBS) cases. From April to December 2008, six patients had a DBS surgical site infection (SSI). Audits of hygiene practices, infection control of the healthcare environment, and preoperative antimicrobial prophylaxis characteristics were carried out. The results of surgical audits showed that skin preparation and antimicrobial prophylaxis were not being performed adequately. In 2008, the general SSI rate was 1.8% (27 SSIs/1471 patients). Length of preoperative stay was significantly longer among infected patients (2.7 ± 2.9 months) compared with uninfected patients (2.2 ± 4.6 months) (P=0.01). Based on these results, skin preparation and antimicrobial prophylaxis were reviewed with the neurosurgery team. In 2009, the general SSI rate was reduced to 1.1% (16 SSI in 1410 patients), a reduction from 2008 (P=0.12). Although the overall incidence of SSI in 2008 (1.8%) was within the range of published data, this surveillance of SSIs permitted identification of site operative infected patients surgically treated for DBS. A set of actions was then taken to reduce SSI risk. This work demonstrates how an active surveillance programme can successfully change clinical care practice.
Insights
Active surveillance of neurosurgical site infections (SSIs) identified an outbreak in deep brain stimulation (DBS) cases. Interventions improved practices, reducing SSI rates and demonstrating the value of surveillance programs.
Area of Science:
- Neurosurgery
- Infectious Disease Epidemiology
- Healthcare Quality Improvement
Background:
- Neurosurgical site infections (SSIs) pose a significant risk to patient outcomes.
- Deep brain stimulation (DBS) procedures carry specific infection risks.
- Effective surveillance is crucial for identifying and mitigating infection outbreaks.
Purpose of the Study:
- To conduct a two-year surveillance of neurosurgical site infections.
- To investigate an outbreak of infections in deep brain stimulation (DBS) cases.
- To evaluate the impact of interventions on SSI rates.
Main Methods:
- Two-year surveillance of neurosurgical site infections (April 2008–2009).
- Audits of hygiene practices, environmental infection control, and antimicrobial prophylaxis.
- Analysis of SSI rates and patient preoperative stay duration.
Main Results:
- An outbreak of six DBS surgical site infections (SSIs) occurred in 2008.
- Audits revealed inadequate skin preparation and antimicrobial prophylaxis.
- The general SSI rate decreased from 1.8% in 2008 to 1.1% in 2009 following interventions.
Conclusions:
- Active surveillance successfully identified an outbreak of SSIs in DBS patients.
- Review and improvement of skin preparation and antimicrobial prophylaxis reduced SSI rates.
- Surveillance programs can drive positive changes in clinical practice to reduce infection risk.
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