Work

1010Cumulative incidence of surgical site infection in patients with prosthetic joint operations in Japan: a 12-month cohort study in a teaching hospital

Year: 2014

Type: article

Abstract: Background. Little is known about incidence for surgical site infection (SSI) after prosthetic joint operations in Japan. We aimed to determine cumulative incidence of SSI after operations of hip replacement (HPRO) or knee replacement (KPRO) during 12-month postoperative periods in a Japanese hospital. Methods. We performed a 12-month retrospective cohort study on all consecutive patients who underwent HPRO or KPRO during 20 months from May 2010 in a 401-bed community-based university-affiliated teaching hospital. Our study design was based on the methodology of the National Healthcare Safety Network (NHSN) and SSI definition was based on the US-CDC criteria. A certified nurse specialist in infection control nursing collected follow-up data and identified SSI in patients with HPRO or KPRO by using electronic medical records. Definition of SSI required double-check and confirmation by a hospitalist physician investigator. Cumulative incidence of SSI was determined and compared to the benchmark data of US or European surveillances. Risk factors for SSI were analyzed using logistic regression model. Results. During the 20-month period, 223 patients underwent prosthetic joint operations. In 12-month follow-up, 26 patients developed SSI with cumulative incidence of 11.7% (95% CI, 7.8-16.6%). In these 26 patients, 19 patients (73%) had superficial incisional SSI. Among 147 patients with HPRO, 6 patients developed SSI with cumulative incidence of 4.1% (95% CI, 1.5-8.7%) and, in these 6 patients, 5 patients (83%) had superficial incisional SSI. Among 76 patients with KPRO, 20 patients developed SSI with cumulative incidence of 26.3% (95% CI, 16.9-37.7%) and, in these 20 patients, 14 patients (70%) had superficial incisional SSI. Based on logistic regression analysis, significant risk factors for SSI included total joint replacement (OR = 33; 95% CI, 14-125) and ASA score ≧3 (OR = 8.26; 95% CI, 1.99-34.3). The cumulative incidence of SSI was significantly greater than those of US (NHSN) or European (ECDC) benchmark surveillance data (P < 0.01). Conclusion. In a Japanese teaching hospital, SSI cumulative incidence was high, although majority of them were considered to be superficial incisional SSI.Implementation for its preventive strategy is needed in Japan. Disclosures. All authors: No reported disclosures.

Source: Open Forum Infectious Diseases

DOI: 10.1093/ofid/ofu052.718

Authors: Tomoko Sakihama, Mikiro Kato, Ryoko Harada, Yasuharu Tokuda

Institutions: International University of Health and Welfare, University of Tsukuba, Mito Kyodo General Hospital, Japan Community Healthcare Organization

Language: English

Topic: Orthopedic Infections and Treatments

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,053