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Matching Bacteriological and Medico-Administrative Databases Is Efficient for a Computer-Enhanced Surveillance of Surgical Site Infections: Retrospective Analysis of 4,400 Surgical Procedures in a French University Hospital

Published online by Cambridge University Press:  10 May 2016

Brice Leclère ,
Camille Lasserre ,
Céline Bourigault ,
Marie-Emmanuelle Juvin ,
Marie-Pierre Chaillet ,
Nicolas Mauduit ,
Jocelyne Caillon ,
Matthieu Hanf ,
Didier Lepelletier  and
SSI Study Group
Brice Leclère
Affiliation:
Department of Bacteriology and Infection Control, Nantes University Hospital, Nantes, France
Camille Lasserre
Affiliation:
Department of Bacteriology and Infection Control, Nantes University Hospital, Nantes, France EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Medical School, University of Nantes, Nantes, France
Céline Bourigault
Affiliation:
Department of Bacteriology and Infection Control, Nantes University Hospital, Nantes, France
Marie-Emmanuelle Juvin
Affiliation:
Department of Bacteriology and Infection Control, Nantes University Hospital, Nantes, France
Marie-Pierre Chaillet
Affiliation:
Department of Medical Information, Nantes University Hospital, Nantes, France
Nicolas Mauduit
Affiliation:
Department of Medical Information, Nantes University Hospital, Nantes, France
Jocelyne Caillon
Affiliation:
Department of Bacteriology and Infection Control, Nantes University Hospital, Nantes, France EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Medical School, University of Nantes, Nantes, France
Matthieu Hanf
Affiliation:
Clinical Investigation Center, Nantes University Hospital, Nantes, France
Didier Lepelletier*
Affiliation:
Department of Bacteriology and Infection Control, Nantes University Hospital, Nantes, France EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Medical School, University of Nantes, Nantes, France Members of the SSI Study Group are listed at the end of the text
SSI Study Group
Affiliation:
Department of Bacteriology and Infection Control, Nantes University Hospital, Nantes, France EA3826 Thérapeutiques Cliniques et Expérimentales des Infections, Medical School, University of Nantes, Nantes, France Members of the SSI Study Group are listed at the end of the text
*
Department of Bacteriology and Infection Control, Nantes University Hospital, Nantes, France ([email protected]).
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Abstract

Objective.

Our goal was to estimate the performance statistics of an electronic surveillance system for surgical site infections (SSIs), generally applicable in French hospitals

Methods.

Three detection algorithms using 2 different data sources were tested retrospectively on 9 types of surgical procedures performed between January 2010 and December 2011 in the University Hospital of Nantes. The first algorithm was based on administrative codes, the second was based on bacteriological data, and the third used both data sources. For each algorithm, sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated. The reference method was the hospital’s routine surveillance: a comprehensive review of the computerized medical charts of the patients who underwent one of the targeted procedures during the study period.

Setting.

A 3,000-bed teaching hospital in western France.

Population.

We analyzed 4,400 targeted surgical procedures.

Results.

Sensitivity results varied significantly between the three algorithms, from 25% (95% confidence interval, 17–33) when using only administrative codes to 87% (80%–93%) with the bacteriological data and 90% (85%–96%) with the combined algorithm. Fewer variations were observed for specificity (91%–98%), PPV (21%–25%), and NPV (98% to nearly 100%). Overall, performance statistics were higher for deep SSIs than for superficial infections.

Conclusions.

A reliable computer-enhanced SSI surveillance can easily be implemented in French hospitals using common data sources. This should allow infection control professionals to spend more time on prevention and education duties. However, a multicenter study should be conducted to assess the generalizability of this method.

Infect Control Hosp Epidemiol 2014;35(11):1330–1335

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 35 , Issue 11 , November 2014 , pp. 1330 - 1335
Copyright
© 2014 by The Society for Healthcare Epidemiology of America. All rights reserved.

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