Surgical site infection rates at the Pontiac Health Care Centre, a rural community hospital

Introduction: The prevalence of surgical site infections (SSIs) at the Pontiac Health Care Centre, a rural hospital, was compared with rates obtained by large multicentre studies. Postoperative nosocomial infection (NI) rates were also calculated. Methods: A review of all surgical interventions involving an incision, excluding ophthalmological procedures, performed between October 2001 and March 2003 (n = 831) was undertaken. Various clinical parameters were recorded. Infection rates were calculated. Data were analyzed using either the X-2 or Student's t test. Results: The overall SSI rate was 5.54%: 3.50% in clean cases (C), 6.77% in clean-contaminated cases (CC), and 14.58% in contaminated or dirty cases (D). The postoperative NI rate was 6.62% (C, 3.68%; CC, 9.90%; D, 16.67%). The mean duration of surgery was significantly higher among patients with SSIs and with NIs than those without infections for CC (133 +/- 95 v. 78 +/- 60 min, p < 0.05, and 129 +/- 82 v. 77 +/- 60 min, p < 0.001 respectively) and D (130 +/- 96 v. 82 +/- 62 min, p < 0.001, and 136 +/- 92 v. 80 +/- 60 min, p < 0.001 respectively). There were significantly higher SSI and NI rates among patients with combined American Society of Anesthesiologists (ASA) scores II and III than those with ASA score I in D (X-2 = 5.06 and X-2 = 6.34 respectively). There was also significantly higher SSI and NI rates among patients with combined Comorbidity Scale score 1-6 than those with no comorbid factors in CC (X-2 = 4.14 and X-2 = 4.42 repectively) and D (not significant and X-2 = 4.04 respectively). Conclusion: SSI rates at the Pontiac Health Care Centre were comparable to multicentre rates. Wound contamination category, type of surgery, duration of surgery, ASA score and Comorbidity Scale score were associated with SSI and NI rates. Studies have shown that examining NI rates decreases these rates by raising awareness; thus, we suggest that rural hospitals implement protocols to survey their postoperative NI rates.