Infections after coronary artery bypass graft surgery in Victorian hospitals - VICNISS Hospital Acquired Infection Surveillance

Objective: To establish a surveillance program reporting surgical site infection rates after coronary artery bypass graft surgery (CABGS) in Victorian public hospitals. Methods: The VICNISS Coordinating Centre was established in 2002 to implement and co-ordinate a standardised surveillance system for hospital-acquired infections in acute care Victorian public hospitals. Using validated definitions and methodology from the Centers for Disease Control and Prevention's National Nosocomial Infection Surveillance (NNIS) program, data on risk-adjusted surgical site infection (SSI) rates were collected and submitted to the Coordinating Centre for collation and reporting. Results: Six large Melbourne metropolitan hospitals contributed data for CABGS for the period 11 November 2002 to 30 June 2004, comprising a total of 3,482 patient records. Of 3,398 complete records, the aggregate SSI rates per 100 procedures for NNIS risk category 1 and 2 were 4.4 (95% CI 3.7-5.3) and 6.0 (95% CI 4.5-7.8) respectively. The deep sternal SSI rates were 0.6 (95% CI 0.4-1.3) and 0.5 (95% CI 0.5-2.4 for patients in risk category 1 and 2 respectively. The most common pathogen identified was Staphylococcus aureus. Conclusion: This early data from VICNISS demonstrates similar CABGS SSI rates to those reported by NNIS in the USA, but higher than reported by the German Nosocomial Infection Surveillance System. Implications: The adoption of a statewide, co-ordinated surveillance program using validated internationally accepted methodologies allows hospitals to benchmark their infection rates against aggregate local and international data and to examine infection prevention interventions.