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Surveillance of surgical site infection in a teaching hospital in Ghana: a prospective cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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BACKGROUND: Surveillance systems for surgical site infections (SSIs), as a measure of patient safety, help health institutions devise strategies to reduce or prevent them. No surveillance systems exist to monitor SSIs in Ghana.

AIM: To establish a system for monitoring trends and detecting outbreaks in order to create awareness of and control SSIs.

METHODS: An active 30-day surveillance was undertaken at the general surgical unit of the Korle Bu Teaching Hospital, from July 1st, 2017 to December 31st, 2018 to identify SSI. It involved a daily inpatient surveillance of patients who had had a surgical procedure, followed by post-discharge surveillance by means of a healthcare personnel-based survey and a patient-based telephone survey. We supplied quarterly feedback of results to surgeons.

FINDINGS: Among the 3267 patients included, 331 were identified with an SSI, a 10% incidence risk. Patients who acquired an SSI experienced increased morbidity including nine extra days in hospital and an adjusted relative mortality risk of 2.3 (95% confidence interval: 1.3 - 4.1; P=0.006) compared to patients without SSI. Forty-nine per cent (161/331) of SSIs were diagnosed post discharge using the healthcare personnel-based survey. The patient-based telephone survey contributed 12 additional cases. SSI incidence risk decreased from 12.8% to 7.5% during the study period.

CONCLUSION: Post-discharge surveillance is feasible using existing healthcare personnel, and the results highlight the high risk and burden of SSIs in Ghana. A surveillance system with feedback for monitoring SSIs may contribute to reducing SSIs; however, firm conclusions regarding the impact need longer observation time.

OriginalsprogEngelsk
TidsskriftThe Journal of hospital infection
Vol/bind104
Udgave nummer3
Sider (fra-til)321-327
Antal sider7
ISSN0195-6701
DOI
StatusUdgivet - mar. 2020

Bibliografisk note

Copyright © 2020 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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