Impact of participation in a surgical site infection surveillance network: results from a large international cohort study.

Background: There are inconsistent data on the risk factors for Clostridium difficile infection (CDI) in the literature. Aims: To use two C. difficile infection (CDI) case-control study groups to compare risk factors in hospitalized patients with diarrhea across different countries. Methods: A multi-center group of CDI cases/controls were identified by standardized testing from seven countries from the prior EUropean, multi-center, prospective biannual point prevalence study of CLostridium difficile Infection in hospitalized patients with Diarrhea (EUCLID). A second group of CDI cases/controls was identified from a single center in Germany [parallel study site (PSS)]. Data were extracted from the medical notes to assess CDI risk factors. Univariate analyses and multivariate logistic regression models were used to identify and compare risk factors between the two groups. Results: There were 253 and 158 cases and 921 and 584 controls in the PSS and EUCLID groups, respectively. Significant variables from univariate analyses in both groups were age ≥65, number of antibiotics (OR 1.2 for each additional antibiotic) and prior hospital admission (all p < 0.001). Congestive heart failure, diabetes, admission from assisted living or Emergency Department, proton pump inhibitors, and chronic renal disease were significant in PSS (all p < 0.05) but not EUCLID. Dementia and admitted Davies et al. Risk Factors for CDI with other bacterial diseases were significant in EUCLID (p < 0.05) but not PSS. Following multivariate analyses, age ≥ 65, number of antibiotics and prior hospital admission were consistently identified as CDI risk factors in each individual group and combined datasets. Conclusion: Our results show that the same CDI risk factors were identified across datasets. These were age ≥ 65 years, antibiotic use and prior hospital admission. Importantly, the odds of developing CDI increases with each extra antibiotic prescribed.

No abstract

No abstract

No abstract

No abstract

CDC) for surgical site infection surveillance. For the calculation of the numbers of operations per 100,000 inhabitants the Hungarian Central Statistics Office's yearly population data was used.Results: Beside the generally monitored categories, like Caesarean section, cholecystectomy, colon surgery and hip prosthesis (with 322.3, 240.7, 144.4 and 122.9 operations per 100000 per year), other, rarely under surveillance operations, frequency was high (herniorrhaphy, exploratory laparotomy, ovarian and breast surgery with 480.6, 282, 131.1 and 114.3 operations per 100000 per year, respectively). Operations with potentially higher infection rates as limb amputation, appendix surgery and hysterectomy (abdominal and vaginal combined) were also frequently performed (102.8, 100.8 and 99 operations per 100000 per year). As known, number of laminectomy, knee prosthesis, cardiac and bypass operations are also considerable, but patients often undergo thoracic, (para)thyroid, small bowel surgery and craniotomy too.Conclusion: Taking into account the high numbers of certain surgical procedures even with low infection rates they can affect numerous patients. Under surveillance elevated attention could force early detection of infection or even more careful application of preventive measures. Surveillance of frequent operation categories with limited number of procedure types involved has to be considered on national or even on European level, e.g. herniorrhaphy, ovarian surgery.

No abstract