Prospective multicenter surveillance and risk factor analysis of deep surgical site infection after posterior thoracic and/or lumbar spinal surgery in adults

Ogihara, Satoshi; Yamazaki, Takashi; Maruyama, Toru; Oka, Hiroyuki; Miyoshi, Katsuhiko; Azuma, Seiichi; Yamada, Takashi; Murakami, Masaya; Kawamura, Naohiro; Hara, Nobuhiro; Terayama, Sei; Morii, Jiro; Kato, So; Tanaka, Sakae

doi:10.1007/s00776-014-0669-1

Cited by 45 publications

(44 citation statements)

References 23 publications

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“…A total of 39 studies evaluating S. aureus SSI rates among patients who underwent spine operations of interest were included in this study (Table 1A) [6,7,10–15,32,37,45,47,48,52,53,62,77,84,90,91,101,103,111–113,117,122,126,129,132,137,138,140,146,155,160,164,167,173]. The pooled average S. aureus SSI rate was calculated to be 1% (median, 2%; range, 0.02%–10%) based on 42 cohorts evaluating a total of 112,135 patients.…”

Section: Resultsmentioning

confidence: 99%

“…According to 13 studies consisting of 14 cohorts with a total of 14,835 patients who underwent instrumented spinal fusion, the calculated pooled average rate was 1.4% (median, 2%; range, 0.1%–10%) [6,37,48,77,84,90,101,112,122,126,132,137,160]. The pooled average contribution of S. aureus infections to spinal SSIs was calculated to be 49.3% (median, 50%; range, 16.7%–100%; 2,272 SSIs) [6,7,10–15,32,37,45,47,48,52,53,62,77,84,90,91,101,103,111–113,117,122,126,129,132,137,138,140,146,155,160,164,167,173]. …”

Section: Resultsmentioning

confidence: 99%

“…There were 30 studies that assessed the proportion of S. aureus SSIs after spine operations of interest that were attributed to MRSA (Table 1B) [6,10–14,22,25,32,37,45,53,62,84,90,111,113,117,122,126,129,137,138,146,155,160,164,167,175,176]. The pooled average proportion of S. aureus SSIs attributable to MRSA was calculated to be 37.9% based on 32 cohorts with a total of 1,071 patients experiencing S. aureus SSIs (median, 42.5%).…”

Section: Resultsmentioning

confidence: 99%

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Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement ofStaphylococcus aureus

Patel¹,

Khoury²,

Girgenti

et al. 2017

Surgical Infections

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Background: Spine operations may be indicated for treatment of diseases including vertebral injuries, degenerative spinal conditions, disk disease, spinal misalignments, or malformations. Surgical site infection (SSI) is a clinically important complication of spine surgery. Staphylococcus aureus, including methicillin-resistant Staphylococcus aureus (MRSA), is a leading cause of post-spinal SSIs.Methods: PubMed and applicable infectious disease conference proceedings were searched to identify relevant published studies. Overall, 343 full-text publications were screened for epidemiologic, mortality, health care resource utilization, and cost data on SSIs associated with specified spine operations.Results: Surgical site infection rates were identified in 161 studies from North America, Europe, and Asia. Pooled average SSI and S. aureus SSI rates for spine surgery were 1.9% (median, 3.3%; range, 0.1%–22.6%) and 1.0% (median, 2.0%; range, 0.02%–10.0%). Pooled average contribution of S. aureus infections to spinal SSIs was 49.3% (median, 50.0%; range, 16.7%–100%). Pooled average proportion of S. aureus SSIs attributable to MRSA was 37.9% (median, 42.5%; range, 0%–100%). Instrumented spinal fusion had the highest pooled average SSI rate (3.8%), followed by spinal decompression (1.8%) and spinal fusion (1.6%). The SSI-related mortality rate among spine surgical patients ranged from 1.1%–2.3% (three studies). All studies comparing SSI and control cohorts reported longer hospital stays for patients with SSIs. Pooled average SSI-associated re-admission rate occurring within 30 d from discharge ranged from 20% to 100% (four studies). Pooled average SSI-related re-operation rate was 67.1% (median, 100%; range, 33.5%–100%). According to two studies reporting direct costs, spine surgical patients incur approximately double the health care costs when they develop an SSI.Conclusions: Available published studies demonstrate a clinically important burden of SSIs related to spine operations and the substantial contribution of S. aureus (including MRSA). Preventive strategies aimed specifically at S. aureus SSIs could reduce health care costs and improve patient outcomes for spine operations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement ofStaphylococcus aureus

Patel¹,

Khoury²,

Girgenti

et al. 2017

Surgical Infections

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“…In our study the duration of surgery was found to be an independent risk factor for SSI (p=0.04). A prospective multicenter surveillance for SSI that enrolled more than 3000 patients by Ogihara et al (2015) 23 and Hennessey et al (2016) 25 and Cheng et al 2017 26 showed that operating time ≥3 hours was found to be significantly associated with an increased risk of SSI (P < 0.0001). The mean operative time was approximately 30 minutes longer in patients with SSIs compared with those patients without.…”

Section: Discussionmentioning

confidence: 99%

<p>Care Bundle Approach to Reduce Surgical Site Infections in Acute Surgical Intensive Care Unit, Cairo, Egypt</p>

Wassef¹,

Mukhtar²,

Nabil³

et al. 2020

IDR

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Introduction: Surgical site infections (SSIs) are one of the most frequently reported hospital acquired infections associated with significant spread of antibiotic resistance. Purpose: We aimed to evaluate a bundle-based approach in reducing SSI at acute surgical intensive care unit of the Emergency Hospital of Cairo University. Patients and Methods: Our prospective study ran from March 2018 to February 2019 and used risk assessment. The study was divided into three phases. Phase I: (pre-bundle phase) for 5 months; data collection, active surveillance of the SSIs, screening for OXA-48 producing Enterobacteriaceae and multidrug resistant Acinetobacter baumannii colonizers using Chrom agars were carried out. Phase II: (bundle-implementation) a 6-S bundle approach included education, training and postoperative bathing with Chlorhexidine Gluconate in collaboration with the infection control team. Finally, Phase III: (post-implementation) for estimation of compliance, rates of colonization, and infection. Results: Phase I encompassed 177 patients, while Phase III included 93 patients. A significant reduction of colonization from 24% to 15% (p<0.001) was observed. Similarly, a decrease of SSI from 27% to 15% (p=0.02) was noticed. A logistic regression was performed to adjust for confounding in the implementation of the bundle and we found a 70% reduction of SSI odd's ratio (OR's ratio = 0.3) confidence interval (95% CI 0.14-0.6) with significant Apache II (p=0.04), type of wound; type II (p=0.002), type III (p=0.001) and duration of surgery (p=0.04) as independent risk factors for SSI. Klebsiella pneumoniae was the most prevalent organism during phase I (34.7%). On the other hand, A. baumannii was the commonest organism to be isolated during phase III with (38.5%) preceding K. pneumoniae (30%). Conclusion: Our study demonstrated that the implementation of a multidisciplinary bundle containing evidence-based interventions was associated with a significant reduction of colonization and SSIs and was met with staff approval and acceptable compliance.

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“…Частота ИОХВ при операциях на позвоночнике, по данным раз-ных исследователей, составляет 0,7-20,0 % [19,31,[59][60][61][62]. Глубокая ИОХВ встречается несколько реже, чем поверхностная, составляя 0,5-3,5 % [27,[63][64][65].…”

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Rate and structure of complications in spine surgery

Fadeev

Михайлович²,

Haydarov

et al. 2017

Pediatr Traum Orthop Reconstr Surg

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The risk of intraoperative and postoperative complications after spinal surgery still remains in the hospital-acquired conditions of any hospital. The methods for performing spinal surgery in children and adults are developing and constantly improving. A significant number of constructions for performing spinal surgery are created by leading manufacturers. The frequency of local and systemic surgical complications has not decreased. Knowing the rate and structure spinal surgery complications can expand the ability to predict and prevent them, which is important for medical science and practice. The presented review of literature addressed the current state of knowledge on spinal surgery complications.

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Prospective multicenter surveillance and risk factor analysis of deep surgical site infection after posterior thoracic and/or lumbar spinal surgery in adults

Cited by 45 publications

References 23 publications

Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement ofStaphylococcus aureus

Burden of Surgical Site Infections Associated with Select Spine Operations and Involvement ofStaphylococcus aureus

<p>Care Bundle Approach to Reduce Surgical Site Infections in Acute Surgical Intensive Care Unit, Cairo, Egypt</p>

Rate and structure of complications in spine surgery

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