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Impact of an Infection Control and Antimicrobial Stewardship Program on Solid Organ Transplantation and Hepatobiliary Surgical Site Infections

Published online by Cambridge University Press:  03 October 2016

Charles Frenette ,
David Sperlea ,
Yveta Leharova  and
Daniel J. G. Thirion
Charles Frenette
Affiliation:
Infectious Diseases Department, McGill University Health Center (MUHC), Montreal, Quebec, Canada
David Sperlea
Affiliation:
Faculté de pharmacie, Université de Montréal, Montreal, Quebec, Canada
Yveta Leharova
Affiliation:
Infection Prevention and Control Department, Royal Victoria Hospital, McGill University Health Center (MUHC), Montreal, Quebec, Canada
Daniel J. G. Thirion*
Affiliation:
Pharmacy Department, McGill University Health Center (MUHC) and Faculté de pharmacie, Université de Montréal, Montreal, Quebec, Canada
*
Address correspondence to Daniel J.G. Thirion, PharmD, FCSHP, Faculté de pharmacie, Université de Montréal, PO Box 6128, succ. Centre-ville, Montreal, Quebec, Canada H3C 3J7 ([email protected]).
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Abstract

OBJECTIVE

The goal of this long-term quasi-experimental retrospective study was to assess the impact of a 5-year serial infection control and antimicrobial stewardship intervention on surgical site infections (SSIs).

METHODS

This study was conducted in a tertiary-care public teaching institution over a 5-year period from January 2010 to December 2014. All patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas–kidney transplantation were included. Outcomes were compared between a preintervention group (2010–2011) and a postintervention group (2012–2014).

RESULTS

A total of 1,424 procedures averaged an overall SSI rate of 11.2%. After implementation of the interventions, a decrease of 52.8% in SSI rates from 17.4% to 8.2% was observed (P<.001; odds ratio [OR], 2.1; 95% confidence interval [CI], 1.5–2.9). An overall significant decrease >50% (relative rate; P<.001) was observed in superficial incisional and organ-space infections between pre- and postintervention groups. In addition, a 54.9% decrease from 19.7% to 8.9% (P<.001; OR, 2.2; 95% CI, 1.4–3.5) and a 51.6% decrease from 15.5% to 7.5% (P=.001; OR, 2.2; 95% CI, 1.4–3.5) were observed for SSI rates in hepatobiliary surgery and solid organ transplantation, respectively. The antimicrobial stewardship intervention increased overall conformity to the internal surgical prophylaxis protocol by 15.2% (absolute rate) from 45.1% to 60.3% (P<.003; 95% CI, 5.4–24.9).

CONCLUSIONS

A long-term serial infection control and antimicrobial stewardship intervention decreased SSIs among patients undergoing hepatobiliary surgery and liver, kidney, pancreas, and simultaneous pancreas–kidney transplantation.

Infect Control Hosp Epidemiol 2016;1468–1474

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 37 , Issue 12 , December 2016 , pp. 1468 - 1474
Copyright
© 2016 by The Society for Healthcare Epidemiology of America. All rights reserved 

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