1887
  1. Home
  2. Eurosurveillance
  3. Volume 29, Issue 11, 14/Mar/2024
  4. Article
Research Open Access
Like 0
Download

Abstract

Background

Surveillance of lower respiratory tract infections (LRTI) of operated patients conventionally focuses on intubated patients in intensive care units (ICU). Post-operative immobilisation increases the risk of LRTI not associated with ventilators. Operated patients, however, have thus far not been a primary target for LRTI surveillance.

Aim

We aimed to describe the applied LRTI surveillance method in the German surveillance module for operated patients (OP-KISS) and to report data between 2018 and 2022.

Methods

Surveillance of LRTI can be performed voluntarily in addition to surgical site infection (SSI) surveillance in OP-KISS. We calculated LRTI rates per 100 operations for all procedures combined, as well as for individual surgical groups and procedures. Additionally, a combined post-operative infection rate (SSI and LRTI) was calculated.

Results

Surveillance of LRTI was performed in 4% of all participating OP-KISS departments and for 2% (23,239 of 1,332,438) of all procedures in the OP-KISS database. The pooled LRTI rate was 0.9 per 100 operations, with marked differences between different types of surgery (3.6 for lobectomies, 0.1 for traumatology and orthopaedics). The share of LRTI among all post-operative infections was highly variable. For lobectomies, the LRTI rate was higher than the SSI rate (3.6 vs 1.5 per 100 operations).

Conclusion

Surveillance of post-operative LRTI is not yet widely adopted by German hospitals. Based on the data in this study, lobectomies represent a prime target for post-operative LRTI surveillance.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2024.29.11.2300416
2024-03-14
2024-05-09
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2024.29.11.2300416
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/29/11/eurosurv-29-11_3.html?itemId=/content/10.2807/1560-7917.ES.2024.29.11.2300416&mimeType=html&fmt=ahah

References

  1. Suetens C, Latour K, Kärki T, Ricchizzi E, Kinross P, Moro ML, et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill. 2018;23(46):1800516.  https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800516  PMID: 30458912 
  2. Behnke M, Aghdassi SJ, Hansen S, Diaz LAP, Gastmeier P, Piening B. The prevalence of nosocomial infection and antibiotic use in German hospitals. Dtsch Arztebl Int. 2017;114(50):851-7.  https://doi.org/10.3238/arztebl.2017.0851  PMID: 29271343 
  3. Metsini A, Vazquez M, Sommerstein R, Marschall J, Voide C, Troillet N, et al. Point prevalence of healthcare-associated infections and antibiotic use in three large Swiss acute-care hospitals. Swiss Med Wkly. 2018;148:w14617. PMID: 29698542 
  4. European Centre for Disease Prevention and Control (ECDC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals. Stockholm: ECDC; Jul 2013. Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/healthcare-associated-infections-antimicrobial-use-PPS.pdf
  5. Lynch JP 3rd. Hospital-acquired pneumonia: risk factors, microbiology, and treatment. Chest. 2001;119(2) Suppl;373S-84S.  https://doi.org/10.1378/chest.119.2_suppl.373S  PMID: 11171773 
  6. Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020;46(5):888-906.  https://doi.org/10.1007/s00134-020-05980-0  PMID: 32157357 
  7. Wolkewitz M, Vonberg RP, Grundmann H, Beyersmann J, Gastmeier P, Bärwolff S, et al. Risk factors for the development of nosocomial pneumonia and mortality on intensive care units: application of competing risks models. Crit Care. 2008;12(2):R44.  https://doi.org/10.1186/cc6852  PMID: 18384672 
  8. Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R, CDC, et al. Guidelines for preventing health-care--associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep. 2004;53(RR-3):1-36. PMID: 15048056 
  9. Plachouras D, Lepape A, Suetens C. ECDC definitions and methods for the surveillance of healthcare-associated infections in intensive care units. Intensive Care Med. 2018;44(12):2216-8.  https://doi.org/10.1007/s00134-018-5113-0  PMID: 29797028 
  10. Gastmeier P, Geffers C, Sohr D, Schwab F, Behnke M, Rüden H. Surveillance nosokomialer Infektionen in Intensivstationen: Aktuelle Daten und Interpretationen. [Surveillance of nosocomial infections in intensive care units. Current data and interpretations]. Wien Klin Wochenschr. 2003;115(3-4):99-103. German.  https://doi.org/10.1007/BF03040287  PMID: 12674685 
  11. German National Reference Centre for Surveillance of Nosocomial Infections (NRZ). Deutsche nationale Punkt-Prävalenzerhebung zu nosokomialen Infektionen und Antibiotika-Anwendung 2016 Abschlussbericht. [German national point prevalence survey on healthcare-associated infections and antimicrobial use. 2016. Final report]. Berlin: NRZ; 2017. German. Available from: https://www.nrz-hygiene.de/files/Projekte/PPS%202016/PPS_2016_Abschlussbericht_20.07.2017.pdf
  12. Thompson MP, Cabrera L, Strobel RJ, Harrington SD, Zhang M, Wu X, et al. Association between postoperative pneumonia and 90-day episode payments and outcomes among Medicare beneficiaries undergoing cardiac surgery. Circ Cardiovasc Qual Outcomes. 2018;11(9):e004818.  https://doi.org/10.1161/CIRCOUTCOMES.118.004818  PMID: 30354549 
  13. Sabaté S, Mazo V, Canet J. Predicting postoperative pulmonary complications: implications for outcomes and costs. Curr Opin Anaesthesiol. 2014;27(2):201-9.  https://doi.org/10.1097/ACO.0000000000000045  PMID: 24419159 
  14. German National Reference Centre for Surveillance of Nosocomial Infections (NRZ). Surveillance postoperativer Atemweginfektionen. [Surveillance of postoperative lower respiratory tract infections]. Berlin: NRZ; 2020. German. Available from: https://www.nrz-hygiene.de/files/Protokolle/OP-Protokolle/Atemweginfektionen/OP_KISS_Protokoll_AWI_v202011.pdf
  15. Gastmeier P, Geffers C, Brandt C, Zuschneid I, Sohr D, Schwab F, et al. Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections. J Hosp Infect. 2006;64(1):16-22.  https://doi.org/10.1016/j.jhin.2006.04.017  PMID: 16820247 
  16. European Centre for Disease Prevention and Control (ECDEC). Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals – protocol version 6.1. Stockholm: ECDC; Oct 2022. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/antimicrobial-use-healthcare-associated-infections-point-prevalence-survey-version6-1.pdf
  17. Aghdassi SJS, Hansen S, Bischoff P, Behnke M, Gastmeier P. A national survey on the implementation of key infection prevention and control structures in German hospitals: results from 736 hospitals conducting the WHO Infection Prevention and Control Assessment Framework (IPCAF). Antimicrob Resist Infect Control. 2019;8(1):73.  https://doi.org/10.1186/s13756-019-0532-4  PMID: 31080588 
  18. Schröder C, Schwab F, Behnke M, Breier AC, Maechler F, Piening B, et al. Epidemiology of healthcare associated infections in Germany: Nearly 20 years of surveillance. Int J Med Microbiol. 2015;305(7):799-806.  https://doi.org/10.1016/j.ijmm.2015.08.034  PMID: 26358916 
  19. Surveillance nosokomialer Infektionen sowie die Erfassung von Krankheits-erregern mit speziellen Resistenzen und Multiresistenzen. [Surveillance of nosocomial infections as well as the detection of pathogens with special resistance and multi-resistance]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(4):580-3. German. https://doi.org/10.1007/s00103-013-1705-6  PMID: 23529603 
  20. Sips ME, Bonten MJM, van Mourik MSM. Semiautomated surveillance of deep surgical site infections after primary total hip or knee arthroplasty. Infect Control Hosp Epidemiol. 2017;38(6):732-5.  https://doi.org/10.1017/ice.2017.37  PMID: 28366180 
  21. Mitchell BG, Hall L, Halton K, MacBeth D, Gardner A. Time spent by infection control professionals undertaking healthcare associated infection surveillance: A multi-centred cross sectional study. Infect Dis Health. 2016;21(1):36-40.  https://doi.org/10.1016/j.idh.2016.03.003 
  22. Metersky ML, Wang Y, Klompas M, Eckenrode S, Mathew J, Krumholz HM. Temporal trends in postoperative and ventilator-associated pneumonia in the United States. Infect Control Hosp Epidemiol. 2023;44(8):1247-54.  https://doi.org/10.1017/ice.2022.264  PMID: 36326283 
  23. Caparelli ML, Shikhman A, Jalal A, Oppelt S, Ogg C, Allamaneni S. Prevention of postoperative pneumonia in noncardiac surgical patients: a prospective study using the National Surgical Quality Improvement Program Database. Am Surg. 2019;85(1):8-14.  https://doi.org/10.1177/000313481908500104  PMID: 30760338 
  24. Chughtai M, Gwam CU, Khlopas A, Newman JM, Curtis GL, Torres PA, et al. The incidence of postoperative pneumonia in various surgical subspecialties: a dual database analysis. Surg Technol Int. 2017;30:45-51. PMID: 28695972 
Surveillance of infections of surgical sites and lower respiratory tracts should be combined: experiences from the German surveillance module for operated patients (OP-KISS), 2018 to 2022
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Seven+Johannes+Sam+Aghdassi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Aghdassi Seven Johannes Sam</a>, <a href="/search?value1=Selin+Saydan&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Saydan Selin</a>, <a href="/search?value1=Michael+Behnke&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Behnke Michael</a>, <a href="/search?value1=J%C3%B6rg+Clausmeyer&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Clausmeyer Jörg</a>, <a href="/search?value1=Petra+Gastmeier&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gastmeier Petra</a>, <a href="/search?value1=Christine+Geffers&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Geffers Christine</a></span>. Surveillance of infections of surgical sites and lower respiratory tracts should be combined: experiences from the German surveillance module for operated patients (OP-KISS), 2018 to 2022. <a href="/content/ecdc">Euro Surveill.</a> 2024;29(11):pii=2300416. <a href="https://doi.org/10.2807/1560-7917.ES.2024.29.11.2300416" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2024.29.11.2300416</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 07 Aug 2023;&nbsp;&nbsp; <span class="generated">Accepted</span>: 16 Dec 2023 </span> </p>
/content/10.2807/1560-7917.ES.2024.29.11.2300416
/content/10.2807/1560-7917.ES.2024.29.11.2300416
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error