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Risk Factors for Surgical Site Infection in a Tanzanian District Hospital: A Challenge for the Traditional National Nosocomial Infections Surveillance System Index

Published online by Cambridge University Press:  21 June 2016

Jan Fehr ,
Christoph Hatz ,
Isaac Soka ,
Patience Kibatala ,
Honorathy Urassa ,
Thomas Smith ,
Hassan Mshinda ,
Reno Frei  and
Andreas Widmer
Jan Fehr
Affiliation:
Department of Medicine and Diagnostics, Swiss Tropical Institute, University Hospital Basel, Basel, Switzerland Division of Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
Christoph Hatz
Affiliation:
Department of Medicine and Diagnostics, Swiss Tropical Institute, University Hospital Basel, Basel, Switzerland
Isaac Soka
Affiliation:
Department of Surgery, St. Francis Designated District Hospital, Ifakara, Tanzania
Patience Kibatala
Affiliation:
Department of Surgery, St. Francis Designated District Hospital, Ifakara, Tanzania
Honorathy Urassa
Affiliation:
Ifakara Health Research and Development Center, Ifakara, Tanzania
Thomas Smith
Affiliation:
Department of Medicine and Diagnostics, Swiss Tropical Institute, University Hospital Basel, Basel, Switzerland
Reno Frei
Affiliation:
Bacteriology Laboratory, University Hospital Basel, Basel, Switzerland
Andreas Widmer*
Affiliation:
Division of Hospital Epidemiology, University Hospital Basel, Basel, Switzerland
*
Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland (awidmer@uhbs.ch)
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Abstract

The incidence of surgical site infections (SSIs) was 24% in a district hospital in Tanzania. Wound classification was not an independent risk factor for SSI, indicating that risk scores developed in industrialized countries may require adjustments for nonindustrialized countries. The National Nosocomial Infections Surveillance system score required adjustments to reliably predict SSI, probably to account for improper hygiene and the lack of adjustment for the duration of surgery (defined as the 75th percentile of the duration for each type of operative procedure) to reflect local circumstances. Multidrug-resistant pathogens, such as methicillin-resistant Staphylococcus aureus and gram-negative pathogens expressing broad-spectrum β-lactamases, have already emerged.

Type
Concise Communications
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 12 , December 2006 , pp. 1401 - 1404
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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