Epidemiologic characteristics of orthopedic surgical site infections and under-reporting estimation of registries using capture-recapture analysis

Abstract

BackgroundSurgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the under-reporting of registries using the capture-recapture method.MethodsThis study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and Health Information Management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N=503). Second, 202 samples were randomly selected to assess patients` characteristics. ResultsTotally, 76.24% of SSIs were detected post-discharge. Staphylococcus aureus (11.38%) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95 % and 65.17%, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95% CI, 552-695) and under-reporting percentage was 63.32%.ConclusionTo recognize the trends of SSIs mortality and morbidity in national level, it is significant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection Prevention and Control (IPC) programs and providing updated protocols is recommended.

In vitro cytocompatibility and antibacterial studies on biodegradable Zn alloys supplemented by a critical assessment of direct contact cytotoxicity assay

“…It was reported that the incidence rate of surgical site infection, accounting globally for about 10%–20% of all nosocomial infections, represents the most common type of health care‐associated infection. The most frequently reported microorganisms are Gram‐negative E. coli and Gram‐positive S. aureus causing implantation site infection in surgical procedures 84 …”

“…The most frequently reported microorganisms are Gram-negative E. coli and Gram-positive S. aureus causing implantation site infection in surgical procedures. 84 Typically, the additions of ions, such as Ag and Cu, to metallic alloys inhibit bacterial growth. 61 Up until now, research has confirmed an antibacterial activity of Ag-rich or Cu-rich Zn-alloys in vitro.…”