TY - JOUR

T1 - Surveillance of surgical site infection in a teaching hospital in Ghana

T2 - a prospective cohort study

AU - Bediako-Bowan, A.

AU - Owusu, E.

AU - Debrah, S.

AU - Kjerulf, A.

AU - Newman, M. J.

AU - Kurtzhals, J. A.L.

AU - Mølbak, K.

PY - 2020

Y1 - 2020

N2 - Background: Surveillance systems for surgical site infections (SSIs), as a measure of patient safety, help health institutions devise strategies to reduce or prevent them. No surveillance systems exist to monitor SSIs in Ghana. Aim: To establish a system for monitoring trends and detecting outbreaks in order to create awareness of and control SSIs. Methods: An active 30-day surveillance was undertaken at the general surgical unit of the Korle Bu Teaching Hospital, from July 1st, 2017 to December 31st, 2018 to identify SSI. It involved a daily inpatient surveillance of patients who had had a surgical procedure, followed by post-discharge surveillance by means of a healthcare personnel-based survey and a patient-based telephone survey. We supplied quarterly feedback of results to surgeons. Findings: Among the 3267 patients included, 331 were identified with an SSI, a 10% incidence risk. Patients who acquired an SSI experienced increased morbidity including nine extra days in hospital and an adjusted relative mortality risk of 2.3 (95% confidence interval: 1.3 - 4.1; P=0.006) compared to patients without SSI. Forty-nine per cent (161/331) of SSIs were diagnosed post discharge using the healthcare personnel-based survey. The patient-based telephone survey contributed 12 additional cases. SSI incidence risk decreased from 12.8% to 7.5% during the study period. Conclusion: Post-discharge surveillance is feasible using existing healthcare personnel, and the results highlight the high risk and burden of SSIs in Ghana. A surveillance system with feedback for monitoring SSIs may contribute to reducing SSIs; however, firm conclusions regarding the impact need longer observation time.

AB - Background: Surveillance systems for surgical site infections (SSIs), as a measure of patient safety, help health institutions devise strategies to reduce or prevent them. No surveillance systems exist to monitor SSIs in Ghana. Aim: To establish a system for monitoring trends and detecting outbreaks in order to create awareness of and control SSIs. Methods: An active 30-day surveillance was undertaken at the general surgical unit of the Korle Bu Teaching Hospital, from July 1st, 2017 to December 31st, 2018 to identify SSI. It involved a daily inpatient surveillance of patients who had had a surgical procedure, followed by post-discharge surveillance by means of a healthcare personnel-based survey and a patient-based telephone survey. We supplied quarterly feedback of results to surgeons. Findings: Among the 3267 patients included, 331 were identified with an SSI, a 10% incidence risk. Patients who acquired an SSI experienced increased morbidity including nine extra days in hospital and an adjusted relative mortality risk of 2.3 (95% confidence interval: 1.3 - 4.1; P=0.006) compared to patients without SSI. Forty-nine per cent (161/331) of SSIs were diagnosed post discharge using the healthcare personnel-based survey. The patient-based telephone survey contributed 12 additional cases. SSI incidence risk decreased from 12.8% to 7.5% during the study period. Conclusion: Post-discharge surveillance is feasible using existing healthcare personnel, and the results highlight the high risk and burden of SSIs in Ghana. A surveillance system with feedback for monitoring SSIs may contribute to reducing SSIs; however, firm conclusions regarding the impact need longer observation time.

KW - Ghana

KW - Monitoring

KW - Surgical site infections

KW - Surveillance

KW - Surveillance system

U2 - 10.1016/j.jhin.2020.01.004

DO - 10.1016/j.jhin.2020.01.004

M3 - Journal article

C2 - 31931045

AN - SCOPUS:85078770037

VL - 104

SP - 321

EP - 327

JO - Journal of Hospital Infection

JF - Journal of Hospital Infection

SN - 0195-6701

IS - 3

ER -