caa a22 4500 38803310X CHVBK 20180307124957.0 cr unu---uuuuu 161130e199805 xx s 000 0 eng 10.1086/647821 doi S0195941700087579 pii (NATIONALLICENCE)cambridge-10.1086/647821 Use of Antibiotic Exposure to Detect Postoperative Infections [Elektronische Daten] OBJECTIVE: To assess the utility of postoperative antibiotic exposure as an indicator of postoperative infection after coronary artery bypass graft surgery. DESIGN: We determined an optimal antibiotic exposure threshold by creating receiver operating characteristic curves. SETTING: Tertiary healthcare institution (United States); national sample (Israel). PATIENTS: 5,887 patients undergoing coronary artery bypass graft surgery. RESULTS: Postoperative antibiotic exposure with at least 9 days between the first and last dates of antibiotic administration, excluding the first postoperative day, had a sensitivity of 95% (261/276) and specificity of 85% (3,944/4,628) for identifying surgical-site infection, using as a gold standard surgical-site infections identified by conventional prospective surveillance or extrapolated from review of a sample of medical records. In contrast, using the same gold standard for surgical-site infections, the sensitivity of routine prospective surveillance alone was only 60%. The predictive value positive of the defined antibiotic exposure was 28% (261/945) for surgical-site infection and 60% (563/945) for any nosocomial infection. In the Israeli cohort, the sensitivity was 87% (74/85) and the specificity was 82% (735/898). CONCLUSION: Antibiotic exposure of sufficient duration and timing was more sensitive than conventional methods in detecting nosocomial infection and required substantially less effort to collect. Although the predictive value positive for surgical-site infection was only moderate, the majority of individuals identified this way had a nosocomial infection Copyright © The Society for Healthcare Epidemiology of America 1998 Yokoe Deborah S. Channing Laboratory and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts Shapiro Mervyn Department of Clinical Microbiology and Infectious Diseases, Hadassah Hospital, Jerusalem, Israel Simchen Elisheva Department of Clinical Microbiology and Infectious Diseases, Hadassah Hospital, Jerusalem, Israel Platt Richard Channing Laboratory and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts Infection Control & Hospital Epidemiology Cambridge University Press 19/5(1998-05), 317-322 0899-823X 19:5<317 1998 19 ICE https://doi.org/10.1086/647821 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1086/647821 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yokoe Deborah S. Channing Laboratory and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts NATIONALLICENCE 700 1- Shapiro Mervyn Department of Clinical Microbiology and Infectious Diseases, Hadassah Hospital, Jerusalem, Israel NATIONALLICENCE 700 1- Simchen Elisheva Department of Clinical Microbiology and Infectious Diseases, Hadassah Hospital, Jerusalem, Israel NATIONALLICENCE 700 1- Platt Richard Channing Laboratory and Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts NATIONALLICENCE 773 0- Infection Control & Hospital Epidemiology Cambridge University Press 19/5(1998-05), 317-322 0899-823X 19:5<317 1998 19 ICE CC0 http://creativecommons.org/publicdomain/zero/1.0 nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-cambridge