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Volume 10, Number 11—November 2004

Research

Enhanced Identification of Postoperative Infections among Inpatients

Deborah S. Yokoe*Comments to Author , Gary A. Noskin†, Susan M. Cunningham†, Gianna Zuccotti‡, Theresa Plaskett‡, Victoria J. Fraser§, Margaret A. Olsen§, Jerome I. Tokars¶, Steven Solomon¶, Trish M. Perl#, Sara E. Cosgrove#, Richard S. Tilson*, Maurice Greenbaum**, David C. Hooper††, Kenneth E. Sands‡‡, John Tully§§, Loreen A. Herwaldt¶¶, Daniel J. Diekema¶¶, Edward S. Wong##, Michael Climo##, and Richard Platt***
Author affiliations: *Brigham and Women's Hospital, Boston, Massachusetts, USA; †Northwestern University, Chicago, Illinois, USA; ‡Memorial Sloan-Kettering Cancer Center, New York, New York, USA; §Washington University School of Medicine, St. Louis, Missouri, USA; ¶Centers for Disease Control and Prevention, Atlanta, Georgia, USA; #Johns Hopkins Medical Institutions, Baltimore, Maryland, USA; **North Shore Medical Center-Salem Hospital, Salem, Massachusetts, USA; ††Massachusetts General Hospital, Boston, Massachusetts, USA; ‡‡Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; §§Mount Auburn Medical Center, Cambridge, Massachusetts, USA; ¶¶University of Iowa Carver College of Medicine, Iowa City, Iowa, USA; ##McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA; ***Harvard Pilgrim Health Care, Boston, Massachusetts, USA

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Table 3

Sensitivity and positive predictive value of routine surveillance and screening by antimicrobial drug exposure, diagnosis codes, or both for identifying SSI after CABG procedures, cesarean delivery, and breast proceduresa

Procedure/phase Sensitivityb (%)
 Positive predictive valueb (%)
Routine surveillance Antimicrobial exposure Diagnosis code Antimicrobial exposure and/or diagnosis code Antimicrobial exposure Diagnosis code Antimicrobial exposure and/or diagnosis code
CABG
Phase 1 79 80 61 87 33 86 35
Phase 2 59 91 54 93 36 84 36
Cesarean delivery
Phase 1 39 90 48 96 42 61 42
Phase 2 38 84 78 97 37 67 38
Breast procedures
Phase 1 71 71 50 79 19 58 20
Phase 2 33 94 70 96 33 79 33

aSSI, surgical site infections; CABG, coronary artery bypass graft.
bCompared to standard criteria comprised of all infections identified during prospective surveillance or medical record review.

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