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Research article
Seyed Saeed Hashemi Nazari
Shahid Beheshti University of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0883-3408
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Surgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the under-reporting of registries using the capture-recapture method.
Methods
This study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and Health Information Management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N=503). Second, 202 samples were randomly selected to assess patients` characteristics.
Results
Totally, 76.24% of SSIs were detected post-discharge. Staphylococcus aureus (11.38%) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95 % and 65.17%, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95% CI, 552-695) and under-reporting percentage was 63.32%.
Conclusion
To recognize the trends of SSIs mortality and morbidity in national level, it is significant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection Prevention and Control (IPC) programs and providing updated protocols is recommended.
Keywords
Surgical site infection, orthopedic surgery, surveillance system, capture-recapture
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CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
Version 3
Posted 16 Dec, 2020
No community comments so far
Submission checks complete
On 06 Dec, 2020
Editorial decision: Accept
On 03 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 27 Nov, 2020
Reviewer #2 agreed
On 24 Oct, 2020
Review #2 received
Received 24 Oct, 2020
Review #1 received
Received 14 Oct, 2020
Reviewers invited
Invitations sent on 07 Oct, 2020
Reviewer #1 agreed
On 07 Oct, 2020
Editor assigned
On 05 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
No comments provided
Editorial decision: Major revision
On 28 Sep, 2020
Review #1 received
Received 25 Sep, 2020
Review #2 received
Received 22 Sep, 2020
Review #3 received
Received 22 Sep, 2020
Reviewer #4 agreed
On 10 Sep, 2020
Reviewer #2 agreed
On 07 Sep, 2020
Reviewer #3 agreed
On 07 Sep, 2020
Reviewer #1 agreed
On 17 Aug, 2020
Reviewers invited
Invitations sent on 19 Jul, 2020
Editor assigned
On 14 Jul, 2020
Submission checks complete
On 30 Jun, 2020
Editor invited
On 30 Jun, 2020
First submitted
On 25 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
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See the published version of this preprint at BMC Infectious Diseases.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Seyed Saeed Hashemi Nazari
Shahid Beheshti University of Medical Sciences
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0883-3408
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Infectious Diseases.
Version 3
Posted 16 Dec, 2020
No community comments so far
Submission checks complete
On 06 Dec, 2020
Editorial decision: Accept
On 03 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 27 Nov, 2020
Reviewer #2 agreed
On 24 Oct, 2020
Review #2 received
Received 24 Oct, 2020
Review #1 received
Received 14 Oct, 2020
Reviewers invited
Invitations sent on 07 Oct, 2020
Reviewer #1 agreed
On 07 Oct, 2020
Editor assigned
On 05 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
No comments provided
Editorial decision: Major revision
On 28 Sep, 2020
Review #1 received
Received 25 Sep, 2020
Review #2 received
Received 22 Sep, 2020
Review #3 received
Received 22 Sep, 2020
Reviewer #4 agreed
On 10 Sep, 2020
Reviewer #2 agreed
On 07 Sep, 2020
Reviewer #3 agreed
On 07 Sep, 2020
Reviewer #1 agreed
On 17 Aug, 2020
Reviewers invited
Invitations sent on 19 Jul, 2020
Editor assigned
On 14 Jul, 2020
Submission checks complete
On 30 Jun, 2020
Editor invited
On 30 Jun, 2020
First submitted
On 25 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Infectious Diseases.
Background
Surgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the under-reporting of registries using the capture-recapture method.
Methods
This study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and Health Information Management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N=503). Second, 202 samples were randomly selected to assess patients` characteristics.
Results
Totally, 76.24% of SSIs were detected post-discharge. Staphylococcus aureus (11.38%) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95 % and 65.17%, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95% CI, 552-695) and under-reporting percentage was 63.32%.
Conclusion
To recognize the trends of SSIs mortality and morbidity in national level, it is significant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection Prevention and Control (IPC) programs and providing updated protocols is recommended.
Figure 1
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