Expert guidance strengthens strategies to prevent most common and costly infection

May 6, 2014

Surgical site infections (SSIs) are the most common and costly healthcare-associated infection (HAI) in the United States. New evidence-based recommendations provide a framework for healthcare institutions to prioritize and implement strategies to reduce the number of infections.

The guidelines are published in the June issue of Infection Control and Hospital Epidemiology and were produced in a collaborative effort led by the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, the American Hospital Association, the Association for Professionals in Infection Control and Epidemiology, and The Joint Commission. The new practice recommendations are a part of Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates.

SSIs occur in as many as five percent of patients undergoing inpatient surgery, amounting to approximately 160,000-300,000 SSI cases each year in the U.S. However, as many as 60 percent of SSIs are preventable by using evidence-based guidelines. Each case is associated with at least seven days of prolonged hospitalization, accounting for at least $3.5 billion in healthcare expenditures annually.

"The evidence-based recommendations released today are broader and more inclusive than other clinical guidelines and include 15 strategies for prevention that go beyond standard practices required by the government or other national organizations," said Deverick Anderson, MD, MPH, co-lead author of the guidelines.

"Formal recommendations can be limited if they rely exclusively on randomized control trial supporting data," said Keith Kaye, MD, MPH, co-lead author of the guidelines. "The current Compendium details strategies that incorporate information from a wider variety of study designs to emulate "real world" scenarios in order to provide practical recommendations for SSI prevention and surveillance."

Below are key strategies included in the guidance:

  • Antimicrobial pre-and-post operative therapy: Healthcare professionals should adhere to appropriate antimicrobial prescribing
  • Preparation and monitoring protocols: Following protocols for proper hair removal, preoperative skin disinfection, and control of blood glucose levels in cardiac patients provides additional methods to help reduce SSIs.
  • Postoperative surveillance: Because the indirect method of SSI surveillance is both reliable and specific, healthcare professionals are urged to use this approach and review microbiology reports, patient medical records, surgeon and patient surveys, and screen for readmission or return to the operating room in an effort to prevent SSIs.

The updated guidelines include a special section on implementation, emphasizing a team-based approach to prevention. These activities include engaging a multidisciplinary team that includes senior leadership and a champion physician in a culture of safety; educating surgical teams, senior leadership, and patients and families on prevention techniques; executing with a focus on reducing barriers and improving adherence with evidence-based practices to lower the risk of SSIs; and evaluating tools, practices and long-term SSI rates.

The 2014 Compendium released today updates the initial 2008 Compendium publication.

Explore further: Expert guidance highlights practices to reduce prevalence of catheter-associated UTIs

More information: Deverick Anderson, Kelly Podgornny, Sandra Berrios-Torres, Dale Bratzler, Patchen Dellinger, Linda Greene, Ann-Christine Nyquist, Lisa Saiman, Deborah Yokoe, Lisa Maragakis, Keith Kaye. "Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update." Infection Control and Hospital Epidemiology 35:6 (June 2014)

Related Stories

Expert guidance highlights practices to reduce prevalence of catheter-associated UTIs

April 8, 2014
New expert guidance highlights strategies for implementing and prioritizing efforts to prevent catheter-associated urinary tract infections (CAUTI) in hospitals. The practice recommendations, published in the May issue of ...

Antibiotics before heart surgery protect against infection

December 23, 2013
A new study found preoperative antibiotic therapy administered within two hours of cardiac surgery decreased the risk of developing surgical site infections (SSIs) significantly. The study was published in the January issue ...

Study finds low rate of surgical site infections following ambulatory surgery

February 18, 2014
In an analysis that included nearly 300,000 patients from eight states who underwent ambulatory surgery (surgery performed on a person who is admitted to and discharged from a hospital on the same day), researchers found ...

National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals

December 12, 2013
The Journal of Hospital Infection (JHI) has just released the awaited epic3 guidelines on infection prevention and control for a range of healthcare professionals. They are freely available online on ScienceDirect and on ...

Modifiable factors ID'd for reducing surgical site infections

September 30, 2013
(HealthDay)—Specific modifiable preoperative, intraoperative, and postoperative factors can be optimized to reduce the risk of surgical site infections (SSIs) for patients undergoing elective orthopedic surgery, according ...

New pediatric infection prevention guidelines for residential facilities

September 18, 2013
With the evolving changes in the delivery of healthcare to children worldwide, which frequently include long-distance travel and lodging for specialized medical treatments, the Society for Healthcare Epidemiology of America ...

Recommended for you

Google searches can be used to track dengue in underdeveloped countries

July 20, 2017
An analytical tool that combines Google search data with government-provided clinical data can quickly and accurately track dengue fever in less-developed countries, according to new research published in PLOS Computational ...

MRSA emerged years before methicillin was even discovered

July 19, 2017
Methicillin resistant Staphylococcus aureus (MRSA) emerged long before the introduction of the antibiotic methicillin into clinical practice, according to a study published in the open access journal Genome Biology. It was ...

New test distinguishes Zika from similar viral infections

July 18, 2017
A new test is the best-to-date in differentiating Zika virus infections from infections caused by similar viruses. The antibody-based assay, developed by researchers at UC Berkeley and Humabs BioMed, a private biotechnology ...

'Superbugs' study reveals complex picture of E. coli bloodstream infections

July 18, 2017
The first large-scale genetic study of Escherichia coli (E. coli) cultured from patients with bloodstream infections in England showed that drug resistant 'superbugs' are not always out-competing other strains. Research by ...

Ebola virus can persist in monkeys that survived disease, even after symptoms disappear

July 17, 2017
Ebola virus infection can be detected in rhesus monkeys that survive the disease and no longer show symptoms, according to research published by Army scientists in today's online edition of the journal Nature Microbiology. ...

Mountain gorillas have herpes virus similar to that found in humans

July 13, 2017
Scientists from the University of California, Davis, have detected a herpes virus in wild mountain gorillas that is very similar to the Epstein-Barr virus in humans, according to a study published today in the journal Scientific ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.