Main Menu Browse by Day or Program Author Keywords

558 Ten Years of Experience in Nationwide Surgical Site Infection Surveillance in Japan

Sunday, April 3, 2011
Trinity Ballroom (Hilton Anatole)
Keita Morikane, MD, PhD , Yamagata University Hospital, Yamagata, Japan
Yasushi Harihara, MD, PhD , Kanto Medical Center, NTT-EC, Tokyo, Japan
Toshiro Konishi, MD, PhD , Kanto Medical Center, NTT-EC, Tokyo, Japan
Background:

There used to be no established surveillance system in Japan prior to the installation of nationwide surgical site infection (SSI) surveillance system, The Japanese Healthcare-Associated Infections Surveillance (JHAIS), in 1999.  The methodology of the system is constructed based on the NNIS system in the US, with some modification of operative procedures that are unique to Japanese populations.  Ten years have passed since the beginning of data collection.

Objective:

To evaluate the trend of SSI rate over the ten years.

Methods:

Data collected through The JHAIS system were used.

Results: In the initial few years, only several hospitals participated in the JHAIS system.  The number of hospitals increased to 50 by the year 2005, when about 20,000 surveyed cases per year were collected for the database.  By the end of 2009, a total of 162,742 cases were surveyed in over 100 hospitals.  The overall SSI ratio in each year decreased significantly.  In 2006, 2007, 2008 and 2009, it was 9.92%(2,482 SSIs in 25,015 operations), 7.56%(2,001/26,453), 7.10%(1,733/24,290), and 7.37%(1,939/26,327), respectively.  The detailed analyses of trend of SSI rate in each participating hospital were performed using the Standardized Infection Ratio (SIR).  Paring of SIR in 2008 with that in 2009 of the same operative procedure in the same hospital yielded 227 pairs of SIRs suitable for comparison.  SIR decreased and increased in 2009 compared to 2008 in 131 and 84 pairs, respectively, showing the decreasing trend of SSI as a whole.  In some hospitals, however, SIRs increased significantly.  Data on six operative procedures in five hospitals were investigated because of their increase in SIRs by 3-fold or more.  Detailed investigations including the possible outbreak were already performed in all hospitals, and change in practice had been done prior to our interview.

Conclusions: Through the continuation of SSI surveillance and participation in The JHAIS system, hospitals in Japan have been successful in controlling SSIs.