Incidence and time trend of surgical site infection in Ramathibodi Hospital during the years 2003-2005.

OBJECTIVE: To determine the incidence of surgical site infection (SSI) for high-risk surgical procedures and any changes in the incidence of SSI during the years 2003 to 2005. MATERIAL AND METHOD: SSI surveillance data were obtained from Ramathobodi's Infection Control Committee for analysis. RESULTS: The overall 30-day incidence of SSI for 492 hepato-biliary-pancreas and colon procedures was 7.7% (38 of 492). Of the 38 SSIs, only 35 were analyzed in detail. MosI patients had SSI types I and II, 89% of SSIs were detected within 20 days after operation, and most common organisms isolated were enterococcus species, E.coli, and P. aeruginosa. SSI rate for the year 2005 (11%) was significantly higher than that of the preceding years (4-5%). CONCLUSION: Overall, SSI rates for Ramathibodi Hospital were not significantly different from those of other studies. The increased SSI rate for the year 2005 needed an explanation, but the value of the present report lies in the potential usefulness of the presented results for future prevention of SSIs. years (4-5%). CONCLUSION: Overall, SSI rates for Ramathibodi Hospital were not significantly different from those of other studies. The increased SSI rate for the year 2005 needed an explanation, but the value of the present report lies in the potential usefulness of the presented results for future prevention of SSIs.

Use of HIV Postexposure Prophylaxis in healthcare workers after occupational exposure: a Thai university hospital setting.

BACKGROUND: PostExposure Prophylaxis (PEP) is widely used after exposures to Human Immunodeficiency Virus (HIV) to reduce the risk of infection in the healthcare setting. Few data are available on the safety and tolerability of Anti Retro Viral drugs (ARV) among Health Care Workers (HCWs) who are prescribed prophylaxis. OBJECTIVE: To collect information about the safety and compliance of taking ARV for HIV PEP among HCWs. MATERIAL AND METHOD: Retrospective review on registry data regarding occupational HIV exposures, the PEP regimens used, and the adverse events associated with PEP was performed. RESULTS: During a five year-period, 820 episodes with occupational blood or body fluid exposures were reported Nurses (27%) were the largest group at risk. The most common type of exposure was percutaneous injuries (82%). Only 125 (15%) HCWs had occupational exposures to HIV, 64 HCWs were prescribed HIV PEP and 32 (50%) HCWs did not complete the PEP regimen as initially prescribed. The commonly prescribed ARV was zidovudine (38%), lamivudine (33%), and indinavir (11%). Overall, 18 (28%) HCWs reported symptoms while on PEP such as nausea (89%), vomiting (55%), and dizziness (39%). None of the HCWs had HIV seroconversion. CONCLUSIONS: Adverse effects from HIV PEP were very common. Clinicians prescribing HIV PEP need to discuss with HCWs about PEP efficacy and side effects. Education efforts aimed at occupational exposure prevention are still important issues.