How should microbiology laboratories interpret cultures of the sonicate of closed needleless connectors? / ¿Cómo deben los laboratorios de microbiología interpretar los cultivos del «sonicado» de los conectores cerrados sin aguja?

Introduction: Our objective was to determine whether there is a cut-off in the needleless connectors’ (NCs) cultures that when combined with skin cultures it was as efficient as conventional superficial cultures to rule-out catheter colonization (CC) and catheter-related bloodstream infection (CRBSI). Methods: During 10 months, we collected samples and then we analyzed the validity values of skin+NCs cultures for CC and CRBSI considering the best cut-off showing at least >90% of specificity to have a high negative predictive value using a ROC curve. Results: We collected a total of 167 catheters. The optimal cut-off of NCs culture was 1000cfu/NC. The validity values for CC and CRBSI combining skin cultures and NCs cultures using the selected cut-off were, respectively: S, 42.9%/16.7%; SP, 83.6%/75.8%; PPV, 27.3%/2.5%; and NPV, 91.0%/96.0%. Conclusions: The combination of skin cultures and quantitative NCs cultures could be used for ruling-out CC and CRBSI.(AU)

Introducción: Nuestro objetivo fue determinar si existe un punto de corte en los cultivos de conectores sin aguja (NC) que, cuando se combina con cultivos de piel, sea tan eficiente como los cultivos superficiales convencionales para descartar colonización de catéter (CC) y bacteriemia relacionada con el catéter (BRC). Métodos: Durante 10 meses se coleccionaron muestras, y después se analizaron los valores de validez de los cultivos de piel + NC para CC y BRC considerando el mejor punto de corte aquel que mostrara al menos >90% de especificidad para tener un alto valor predictivo negativo usando una curva ROC. Resultados: Se estudiaron un total de 167 catéteres. El punto de corte óptimo del cultivo de NC fue de 1.000ufc/NC. Los valores de validez para CC y BRC combinando cultivos de piel y cultivos de NC utilizando el punto de corte seleccionado fueron, respectivamente: S: 42,9/16,7%; ES: 83,6/75,8%; VPP: 27,3/2,5% y VPN: 91,0/96,0%. Conclusiones: La combinación de cultivos de piel y cultivos cuantitativos de NC podría usarse para descartar CC y BRC.(AU)

Incidencia de infección de localización quirúrgica en cirugía de colon según metodología RENAVE: estudio prospectivo 2017-2019 / Incidence of surgical site infection in colon surgery according to RENAVE methodology: Prospective study 2017-2019

INTRODUCCIÓN: El Complejo Hospitalario de Navarra, centro sanitario de tercer nivel, implementó a partir de 2016 un nuevo sistema de vigilancia y control de infecciones relacionadas con la asistencia sanitaria según metodología de la Red Nacional de Vigilancia Epidemiológica. Las infecciones del lugar quirúrgico constituyen uno de los efectos adversos más relevantes, siendo la cirugía de colon un procedimiento de vigilancia obligatoria. Este sistema permitirá al hospital conocer sus tasas de infección quirúrgica, contrastarlas periódicamente para vigilar su tendencia y compararlas con las de otras instituciones sanitarias nacionales y europeas. MÉTODOS: Cuatrocientos dieciséis pacientes intervenidos de colon durante 2017-2019 fueron estudiados prospectivamente durante su hospitalización y hasta los 30días post-cirugía y estratificados según el riesgo de infección quirúrgica mediante el «índice NHSN» (National Health Safety Network). Se realizó un análisis estadístico descriptivo univariante y se calculó la incidencia acumulada de infección de lugar quirúrgico, global y por subgrupos según factores de riesgo. RESULTADOS: La incidencia acumulada global de infección del lugar quirúrgico fue del 10,6% (n = 44), con mayor incidencia en subgrupos de alto riesgo quirúrgico: un 25,0% en la categoría 2 del índice NHSN y un 42,9% en la categoría 3. CONCLUSIONES: La incidencia acumulada de infección del lugar quirúrgico obtenida es similar a la calculada en otros estudios realizados en condiciones semejantes, pero existe una diversidad metodológica que hace compleja la interpretación

BACKGROUND: Navarra Hospital Complex has renovated its healthcare-associated infections surveillance and control methods meeting the requirements of the Spanish National Epidemiologic Surveillance Network. Surgical site infections are one of the most relevant adverse outcomes, being the colon surgery one of the mandatory monitored procedures. This system will ease, not only the yearly estimation of the hospital surgical infection rates, but also its comparison at national and European levels. METHODS: 416 patients underwent surgery between 2017 and 2019. Clinical variables were gathered during the patient hospitalization and up to 30days from surgery, stratifying the cases by their NHSN (National Health Safety Network) surgical infection risk index. A univariant descriptive analysis was performed and outcome indicators were estimated. RESULTS: The cumulative incidence was 10.6%, with 44 cases. The rates were higher among the high-risk subgroups: 25.0% and 42.9%, respectively, for NSHN index categories 2 and 3. CONCLUSIONS: The incidence was similar to the ones found in other studies carried out in analogous conditions. However, the methodologic variability makes it difficult to compare results

Incidence of surgical site infection in colon surgery according to RENAVE methodology: Prospective study 2017-2019. / Incidencia de infección de localización quirúrgica en cirugía de colon según metodología RENAVE: estudio prospectivo 2017-2019.

BACKGROUND: Navarra Hospital Complex has renovated its healthcare-associated infections surveillance and control methods meeting the requirements of the Spanish National Epidemiologic Surveillance Network. Surgical site infections are one of the most relevant adverse outcomes, being the colon surgery one of the mandatory monitored procedures. This system will ease, not only the yearly estimation of the hospital surgical infection rates, but also its comparison at national and European levels. METHODS: 416 patients underwent surgery between 2017 and 2019. Clinical variables were gathered during the patient hospitalization and up to 30days from surgery, stratifying the cases by their NHSN (National Health Safety Network) surgical infection risk index. A univariant descriptive analysis was performed and outcome indicators were estimated. RESULTS: The cumulative incidence was 10.6%, with 44 cases. The rates were higher among the high-risk subgroups: 25.0% and 42.9%, respectively, for NSHN index categories2 and3. CONCLUSIONS: The incidence was similar to the ones found in other studies carried out in analogous conditions. However, the methodologic variability makes it difficult to compare results.

How should microbiology laboratories interpret cultures of the sonicate of closed needleless connectors?

INTRODUCTION: Our objective was to determine whether there is a cut-off in the needleless connectors' (NCs) cultures that when combined with skin cultures it was as efficient as conventional superficial cultures to rule-out catheter colonization (CC) and catheter-related bloodstream infection (CRBSI). METHODS: During 10 months, we collected samples and then we analyzed the validity values of skin+NCs cultures for CC and CRBSI considering the best cut-off showing at least >90% of specificity to have a high negative predictive value using a ROC curve. RESULTS: We collected a total of 167 catheters. The optimal cut-off of NCs culture was 1000cfu/NC. The validity values for CC and CRBSI combining skin cultures and NCs cultures using the selected cut-off were, respectively: S, 42.9%/16.7%; SP, 83.6%/75.8%; PPV, 27.3%/2.5%; and NPV, 91.0%/96.0%. CONCLUSIONS: The combination of skin cultures and quantitative NCs cultures could be used for ruling-out CC and CRBSI.