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http://dx.doi.org/10.3340/jkns.2018.0118

Prospective Multicenter Surveillance Study of Surgical Site Infection after Spinal Surgery in Korea : A Preliminary Study  

Jeong, Tae Seok (Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine)
Yee, Gi Taek (Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine)
Publication Information
Journal of Korean Neurosurgical Society / v.61, no.5, 2018 , pp. 608-617 More about this Journal
Abstract
Objective : This study aimed to investigate the rates, types, and risk factors of surgical site infection (SSI) following spinal surgery using data from a Korean SSI surveillance system that included diagnoses made by surgeons. Methods : This was a prospective observational study of patients who underwent spinal surgeries at 42 hospitals in South Korea from January 2017 to December 2017. The procedures included spinal fusion, laminectomy, discectomy, and corpectomy. Univariate and multivariate logistic regression analyses were performed. Results : Of the 3080 cases included, 30 showed infection, and the overall SSI rate was 1.0% (an incidence of 1.2% in spinal fusion and 0.6% in laminectomy). Deep incisional infections were the most common type of SSIs (46.7%). Gram-positive bacteria caused 80% of the infections, and coagulase-negative staphylococci, including Staphylococcus epidermidis, accounted for 58% of the gram-positive bacteria. A longer preoperative hospital stay was significantly associated with the incidence of SSI after both spinal fusion and laminectomy (p=0.013, p<0.001). A combined operation also was associated with SSI after laminectomy (p=0.032). Conclusion : An SSI surveillance system is important for the accurate analysis of SSI. The incidence of SSI after spinal surgery assessed by a national surveillance system was 1.0%. Additional data collection will be needed in future studies to analyze SSI in spinal surgery.
Keywords
Surgical site infection; Spine; Spinal fusion; Laminectomy; Risk factors;
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1 American Society of Anesthesiologists : ASA Physical Status Classification System. Available at : https://www.asahq.org/resources/clinical-information/asa-physical-status-classification-system
2 Blam OG, Vaccaro AR, Vanichkachorn JS, Albert TJ, Hilibrand AS, Minnich JM, et al. : Risk factors for surgical site infection in the patient with spinal injury. Spine (Phila Pa 1976) 28 : 1475-1480, 2003
3 Centers for Disease Control and Prevention (CDC). National Healthcare Safety Network (NHSN): Surgical site infection (SSI) event. Available at : http://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf
4 Moazzez A, Kelso RL, Towfigh S, Sohn H, Berne TV, Mason RJ : Breast abscess bacteriologic features in the era of community-acquired methicillin-resistant Staphylococcus aureus epidemics. Arch Surg 142 : 881-884, 2007   DOI
5 Olsen MA, Mayfield J, Lauryssen C, Polish LB, Jones M, Vest J, et al. : Risk factors for surgical site infection in spinal surgery. J Neurosurg 98(2 Suppl) : 149-155, 2003
6 Olsen MA, Nepple JJ, Riew KD, Lenke LG, Bridwell KH, Mayfield J, et al. : Risk factors for surgical site infection following orthopaedic spinal operations. J Bone Joint Surg Am 90 : 62-69, 2008
7 Perry JW, Montgomerie JZ, Swank S, Gilmore DS, Maeder K : Wound infections following spinal fusion with posterior segmental spinal instrumentation. Clin Infect Dis 24 : 558-561, 1997   DOI
8 Dixon RE; Centers for Disease Control and Prevention (CDC) : Control of health-care-associated infections, 1961-2011. MMWR Suppl 60 : 58-63, 2011
9 Centers for Disease Control and Prevention (CDC). National Healthcare Safety Network (NHSN): Surveillance Definitions for Specific Types of Infections. Available at : https://www.cdc.gov/nhsn/pdfs/pscmanual/17pscnosinfdef_current.pdf
10 Shaw FE, Kohl KS, Lee LM, Thacker SB; Centers for Disease Control and Prevention (CDC) : Public health then and now: Celebrating 50 years of MMWR at CDC. Introduction. MMWR Suppl 60 : 2-6, 2011
11 Emori TG, Gaynes RP : An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 6 : 428-442, 1993   DOI
12 Wimmer C, Gluch H, Franzreb M, Ogon M : Predisposing factors for infection in spine surgery: a survey of 850 spinal procedures. J Spinal Disord 11 : 124-128, 1998
13 Picada R, Winter RB, Lonstein JE, Denis F, Pinto MR, Smith MD, et al. : Postoperative deep wound infection in adults after posterior lumbosacral spine fusion with instrumentation: incidence and management. J Spinal Disord 13 : 42-45, 2000   DOI
14 Plowman R : The socioeconomic burden of hospital acquired infection. Euro Surveill 5 : 49-50, 2000   DOI
15 Watanabe M, Sakai D, Matsuyama D, Yamamoto Y, Sato M, Mochida J : Risk factors for surgical site infection following spine surgery: efficacy of intraoperative saline irrigation. J Neurosurg Spine 12 : 540-546, 2010   DOI
16 Wu PC, Kuo HK, Li M, Lai IC, Fang PC, Lin SA, et al. : Nosocomial postoperative endophthalmitis: a 14-year review. Graefes Arch Clin Exp Ophthalmol 244 : 920-929, 2006   DOI
17 Jeong SJ, Choi SW, Youm JY, Kim HW, Ha HG, Yi JS : Microbiology and epidemiology of infectious spinal disease. J Korean Neurosurg Soc 56 : 21-27, 2014   DOI
18 Favre B, Hugonnet S, Correa L, Sax H, Rohner P, Pittet D : Nosocomial bacteremia: clinical significance of a single blood culture positive for coagulase-negative staphylococci. Infect Control Hosp Epidemiol 26 : 697-702, 2005   DOI
19 Gaynes RP, Culver DH, Horan TC, Edwards JR, Richards C, Tolson JS : Surgical site infection (SSI) rates in the United States, 1992-1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis 33 Suppl 2 : S69-S77, 2001   DOI
20 Haley RW, Culver DH, White JW, Morgan WM, Emori TG, Munn VP, et al. : The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 121 : 182-205, 1985   DOI
21 John Jr JF, Davidson R, Low DE : Staphylococcus epidermidis and other coagulase-negative staphylococci. Available at : http://www.antimicrobe.org/new/b234.asp#t11
22 Fang A, Hu SS, Endres N, Bradford DS : Risk factors for infection after spinal surgery. Spine (Phila Pa 1976) 30 : 1460-1465, 2005   DOI
23 Klein JD, Hey LA, Yu CS, Klein BB, Coufal FJ, Young EP, et al. : Perioperative nutrition and postoperative complications in patients undergoing spinal surgery. Spine (Phila Pa 1976) 21 : 2676-2682, 1996   DOI
24 Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR; The Hospital Infection Control Practices Advisory Committee : Guideline for prevention of surgical site infection, 1999. Am J Infect Control 27 : 97-134, 1999   DOI
25 Marculescu CE, Berbari EF, Cockerill FR 3rd, Osmon DR : Unusual aerobic and anaerobic bacteria associated with prosthetic joint infections. Clin Orthop Relat Res 451 : 55-63, 2006   DOI
26 Ziebuhr W, Hennig S, Eckart M, Kranzler H, Batzilla C, Kozitskaya S : Nosocomial infections by Staphylococcus epidermidis: how a commensal bacterium turns into a pathogen. Int J Antimicrob Agents 28 Suppl 1 : S14-S20, 2006