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      Applicability of the national nosocomial infections surveillance system risk index for the prediction of surgical site infections: a review

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          Abstract

          This review outlines the evolution of risk rates of surgical site infection adopted by the Study on the Efficacy of Nosocomial Infection Control (SENIC) and the National Nosocomial Infections Surveillance (NNIS) system, and evaluates their advantages and limitations. The types of surgical procedures for which the NNIS index has proven to be an efficient system for the classification of patients are presented. The necessity of adapting the NNIS index to take into account specific characteristics associated with hospitals and practices in various regions and countries is stressed. The requirement for further testing and development of the rate concerning specific procedures, particularly those involving orthopaedic surgery, is discussed.

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          Most cited references77

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          Surgical site infection (SSI) rates in the United States, 1992-1998: the National Nosocomial Infections Surveillance System basic SSI risk index.

          By use of the National Nosocomial Infections Surveillance (NNIS) System's surgical patient surveillance component protocol, the NNIS basic risk index was examined to predict the risk of a surgical site infection (SSI). The NNIS basic SSI risk index is composed of the following criteria: American Society of Anesthesiologists score of 3, 4, or 5; wound class; and duration of surgery. The effect when a laparoscope was used was also determined. Overall, for 34 of the 44 NNIS procedure categories, SSI rates increased significantly (P< .05) with the number of risk factors present. With regard to cholecystectomy and colon surgery, the SSI rate was significantly lower when the procedure was done laparoscopically within each risk index category. With regard to appendectomy and gastric surgery, use of a laparoscope affected SSI rates only when no other risk factors were present. The NNIS basic SSI index is useful for risk adjustment for a wide variety of procedures. For 4 operations, the use of a laparoscope lowered SSI risk, requiring modification of the NNIS basic SSI risk index.
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            CAPD peritonitis. Incidence, pathogens, diagnosis, and management.

            M Saklayen (1990)
            Peritonitis is a frequent complication of CAPD. Sixty percent of all patients on CAPD will have at least one episode of peritonitis during the first year of this mode of dialysis. Most of the episodes of peritonitis are caused by touch contamination of the dialysis tubing or by extension of the catheter exit site or tunnel infection. Coagulase-negative and coagulase-positive Staphylococcus are the two most common organisms, accounting for 50% or more of all CAPD peritonitis. Other gram-positive and gram-negative bacteria and fungi account for the rest. Intraperitoneal antibiotic treatments are usually effective in eradicating the infection. The choice of antibiotics depends on organisms isolated from cultured dialysate. Fungal peritonitis and, occasionally, Pseudomonas peritonitis require removal of the catheter to eradicate the infection. Prompt identification and treatment of peritonitis are essential to ensure success of a CAPD program. Although with newer techniques, like Y-connector or ultraviolet light system, the rate of peritonitis has declined; however, it has still remained the major complication of the CAPD program.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                bjid
                Brazilian Journal of Infectious Diseases
                Braz J Infect Dis
                Brazilian Society of Infectious Diseases (Salvador )
                1678-4391
                February 2007
                : 11
                : 1
                : 134-141
                Affiliations
                [1 ] Universidade Federal de Minas Gerais Brazil
                [2 ] Universidade Federal de Minas Gerais Brazil
                Article
                S1413-86702007000100028
                10.1590/S1413-86702007000100028
                4db08aea-51b0-455b-b6e1-4e1ae73c522d

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=1413-8670&lng=en
                Categories
                INFECTIOUS DISEASES

                Infectious disease & Microbiology
                SSI,quality indicators,hospital infections,surgical procedures,orthopaedic operations

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