Addressing an increase in surgical site infections during the COVID-19 pandemic-Identifying opportunities during a chaotic time
- PMID: 37355097
- PMCID: PMC10286569
- DOI: 10.1016/j.ajic.2023.06.015
Addressing an increase in surgical site infections during the COVID-19 pandemic-Identifying opportunities during a chaotic time
Abstract
Background: Health care systems saw increases in device-associated infections and decreases in surgical site infections (SSI) during the COVID-19 pandemic. However, following an increase in SSIs, an acute care hospital assessed the risk and preventative factors of SSIs among patients.
Methods: A retrospective cohort study on surgeries performed between January 2020 and September 2021 analyzed associations of SSI with risk and preventive factors utilizing χ2, t-tests, and odds ratios. A secondary analysis was utilized to determine the association of case urgency and prevention practice performance.
Results: There was a significant difference in the administration of correct perioperative antibiotic selection between SSI (78.1%) and non-SSI (86.2%) along with 2.9 greater odds of developing an SSI with incorrect perioperative antibiotics. Patients who had urgent cases were significantly less likely than elective to receive preoperative chlorhexidine gluconate wipes (81.6%, 61.5%, respectively), correct antibiotic selection and timing (93.2%, 70.8%, respectively) and chlorhexidine and alcohol skin preparation (81.6%, 67.5%, respectively).
Discussion: Disruption of perioperative workflow during the COVID-19 pandemic likely resulted in an increase in SSI. Numerous opportunities were identified for focused prevention efforts.
Conclusions: The next steps include implementing strategies to improve SSI prevention and establish a culture that can withstand workflow disruptions to maintain a safe environment during significant changes.
Keywords: Infection prevention; Perioperative; Prevention; Retrospective cohort study.
Copyright © 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
References
-
- Fakih M.G., Bufalino A., Sturm L., Huang R.H., Ottenbacher A., Saake K., et al. Coronavirus disease 2019 (COVID-19) pandemic, central-line-associated bloodstream infection (CLABSI), and catheter-associated urinary tract infection (CAUTI): The urgent need to refocus on hardwiring prevention efforts. Infect Control Hosp Epidemiol. 2022 Jan;43(1):26–31. doi: 10.1017/ice.2021.70. Epub 2021 Feb 19. - DOI - PMC - PubMed
-
- Baker M.A., Sands K.E., Huang S.S., Kleinman K., Septimus E.J., Varma N., et al. CDC Prevention Epicenters Program. The Impact of Coronavirus Disease 2019 (COVID-19) on Healthcare-Associated Infections. Clin Infect Dis. 2022 May 30;74(10):1748–1754. doi: 10.1093/cid/ciab688. PMID: 34370014; PMCID: PMC8385925. - DOI - PMC - PubMed
-
- Humphrey T., Daniell H., Chen A.F., Hollenbeck B., Talmo C., Fang C.J., et al. Effect of the COVID-19 Pandemic on Rates of Ninety-Day Peri-Prosthetic Joint and Surgical Site Infections after Primary Total Joint Arthroplasty: A Multicenter, Retrospective Study. Surg Infect (Larchmt) 2022 Jun;23(5):458–464. doi: 10.1089/sur.2022.012. Epub 2022 May 20. PMID: 35594331. - DOI - PubMed
-
- Smith B.B., Bosch W., O'Horo J.C., Girardo M.E., Bolton P.B., Murray A.W., et al. Surgical site infections during the COVID-19 era: A retrospective, multicenter analysis. Am J Infect Control. 2023 Jun;51(6):607–611. doi: 10.1016/j.ajic.2022.09.022. Epub 2022 Sep 23. PMID: 36162605; PMCID: PMC9500048. - DOI - PMC - PubMed
-
- Sybert M., Oakley C.T., Christensen T., Bosco J., Schwarzkopf R., Slover J. Impact of COVID-19 Protocols on Primary and Revision Total Hip Arthroplasty. J Arthroplasty. 2022 Nov;37(11):2193–2198. doi: 10.1016/j.arth.2022.05.035. Epub 2022 May 19. PMID: 35598760; PMCID: PMC9119172. - DOI - PMC - PubMed
