PubMed · 10735161
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S Barrett. 2000. MRSA control guidelines.. https://pubmed.ncbi.nlm.nih.gov/10735161/
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By use of the National Nosocomial Infections Surveillance (NNIS) System's surgical patient surveillance component protocol, the NNIS basic risk index was examined to predict the risk of a surgical site infection (SSI). The NNIS basic SSI risk index is composed of the following criteria: American Society of Anesthesiologists score of 3, 4, or 5; wound class; and duration of surgery. The effect when a laparoscope was used was also determined. Overall, for 34 of the 44 NNIS procedure categories, SSI rates increased significantly (P< .05) with the number of risk factors present. With regard to cholecystectomy and colon surgery, the SSI rate was significantly lower when the procedure was done laparoscopically within each risk index category. With regard to appendectomy and gastric surgery, use of a laparoscope affected SSI rates only when no other risk factors were present. The NNIS basic SSI index is useful for risk adjustment for a wide variety of procedures. For 4 operations, the use of a laparoscope lowered SSI risk, requiring modification of the NNIS basic SSI risk index.
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Infections are a major determinant of the outcome of solid-organ transplantation. Their incidence varies because of a number of factors. The type of organ transplanted, the degree of immunosuppression, the need for additional antirejection therapy, and the occurrence of technical or surgical complications all affect the incidence of infection after transplantation. There are 3 general time frames to consider. In the first month, bacterial and candidal infections predominate. From the second through the sixth months, infections "classically" associated with transplantation become manifest. Beyond the sixth month, the clinical course is largely determined by the presence or absence of chronic rejection.