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Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)

Eu Suk Kim MD, Hong Bin Kim MD, Kyoung-Ho Song MD, Young Keun Kim MD, Hyung-Ho Kim MD, Hye Young Jin RN, Sun Young Jeong RN, Joohon Sung MD, Yong Kyun Cho MD, Yeong-Seon Lee PhD, Hee-Bok Oh PhD, Eui-Chong Kim MD, June Myung Kim MD, Tae Yeol Choi MD, Hee Jung Choi MD, Hyo Youl Kim MD and Korean Nosocomial Infections Surveillance System (KONIS)
Infection Control and Hospital Epidemiology
Vol. 33, No. 6 (June 2012), pp. 572-580
DOI: 10.1086/665728
Stable URL: http://www.jstor.org/stable/10.1086/665728
Page Count: 9
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Prospective Nationwide Surveillance of Surgical Site Infections after Gastric Surgery and Risk Factor Analysis in the Korean Nosocomial Infections Surveillance System (KONIS)
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Abstract

Objective. To evaluate the risk factors for surgical site infection (SSI) after gastric surgery in patients in Korea.Design. A nationwide prospective multicenter study.Setting. Twenty university-affiliated hospitals in Korea.Methods. The Korean Nosocomial Infections Surveillance System (KONIS), a Web-based system, was developed. Patients in 20 Korean hospitals from 2007 to 2009 were prospectively monitored for SSI for up to 30 days after gastric surgery. Demographic data, hospital characteristics, and potential perioperative risk factors were collected and analyzed, using multivariate logistic regression models.Results. Of the 4,238 case patients monitored, 64.9% (2,752) were male, and mean age (±SD) was 58.8 (±12.3) years. The SSI rates were 2.92, 6.45, and 10.87 per 100 operations for the National Nosocomial Infections Surveillance system risk index categories of 0, 1, and 2 or 3, respectively. The majority (69.4%) of the SSIs observed were organ or space SSIs. The most frequently isolated microorganisms were Staphylococcus aureus and Klebsiella pneumoniae. Male sex (odds ratio [OR], 1.67 [95% confidence interval (CI), 1.09–2.58]), increased operation time (1.20 [1.07–1.34] per 1-hour increase), reoperation (7.27 [3.68–14.38]), combined multiple procedures (1.79 [1.13–2.83]), prophylactic administration of the first antibiotic dose after skin incision (3.00 [1.09–8.23]), and prolonged duration (≥7 days) of surgical antibiotic prophylaxis (SAP; 2.70 [1.26–5.64]) were independently associated with increased risk of SSI.Conclusions. Male sex, inappropriate SAP, and operation-related variables are independent risk factors for SSI after gastric surgery.

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