What are the consequences of antibiotic resistance on surgical site infections? In particular, there is concern about the rise in SSIs due to vancomycin-resistant enterococci (VRE), Methicillin-resistant Staphylococcus aureus (MRSA), third generation cephalosporin-resistant Escherichia coli, and imipenem- and quinolone-resistant Pseudomonas aeruginosa. Microorganisms acquire resistance through evolution and adaptation. “Resistance” is the term used to describe the ability of a microorganism to withstand the effects of an antimicrobial agent. The risk of SSI caused by resistant bacteria has become a major concern for hospitals and healthcare professionals. How important is the issue of antibiotic resistance in the context of surgical site infections? The most common pathogens responsible for SSI are presented in Table II. Exogenous sources of microorganisms include surgical instruments, operating room surfaces, the air, and personnel. Causative pathogens depend on surgical site for example, the risk of developing SSI from enteric gram-negative microorganisms increases with surgery on the gastrointestinal tract. Surgical site infections may also be caused by organisms within the patient’s body that are exposed during surgery. Gram-positive bacteria such as Staphylococcus aureus are the most common causative skin-dwelling microorganisms.
#Que es principles of asepsis skin
Most SSIs are caused by endogenous microorganisms present on the patient’s skin when the surgical incision is made. Surgical site infections may be caused by endogenous or exogenous microorganisms. What is the microbiology of surgical site infections? These wide variations in cost of care reflect the complex nature of SSIs, which may substantially differ in severity depending on the causative pathogen, type of surgical procedure performed, patient’s underlying health condition, and other factors. At a rate of 5 SSIs per 100 surgical procedures, the total annual cost of treating SSIs was projected at $3.2 to $10 billion. Higher costs of care were reported in a 2009 study by a CDC economist (Scott RD), who estimated the cost of treating SSI at $10,443 to $25,546. Patients who were readmitted after discharge incurred higher costs of over $5,000. without infection, the median direct costs of hospitalization were $7,531 for infected patients and $3,844 for uninfected patients. In a comparison study (Kirkland KB, 1999) of surgical patients with vs. Occurrence of SSI is estimated to increase hospital stay by 7 to 10 days and add over $3,000 in costs of care. In 2002, SSIs contributed to 8205 deaths.
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Patients with SSI are twice as likely to die, 60% more likely to be admitted to the intensive care unit, and more than five times more likely to be readmitted to the hospital after discharge. Surgical site infections are associated with substantial morbidity and mortality. What are the consequences of surgical site infections? hospitals in 2002, accounting for 20% of all healthcare-associated infections and nearly 2% of all monitored surgical procedures. A study by Klevens RM et al using all of these data sources determined that 244,385 SSIs were reported in U.S. The American Hospital Association also compiles statistics through an annual survey. In the United States, the incidence of SSI is tracked by the National Nosocomial Infections Surveillance (NNIS) system and the National Hospital Discharge Survey, both sponsored by the CDC. What is the incidence of surgical site infections? Incisional infections are further classified as superficial or deep. Infections are classified as either incisional or organ/space infections to differentiate those that occur at the incision site from those related to the organ or space manipulated during surgery. Surgical site infections are defined as infections that occur 30 days after surgery with no implant, or within 1 year if an implant is placed and infection appears to be related to surgery. This chapter describes the types of SSI, lists risk factors, and explains prevention strategies.
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According to NNIS data, SSIs are the third most frequently reported nosocomial infection and are associated with substantial morbidity that can endanger a patient’s life, increase the number of days in the hospital, and increase healthcare costs. Trends in the incidence of SSI are monitored by the National Nosocomial Infections Surveillance (NNIS) system of the Centers for Disease Control and Prevention (CDC).
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Surgical site infections What is the impact of surgical site infections?Īpproximately 27 million surgical procedures are performed in the United States each year, with up to 5% resulting in surgical site infections (SSI).