Analysis of Italian Requests for Compensation in Cases of Responsibility for Healthcare-related Infections: A Retrospective Study

Overview

Journal Front Public Health

Specialty Public Health

Date 2023 Jan 23

PMID 36684913

Authors

Maricla Marrone

Pierluigi Caricato

Federica Mele

Mirko Leonardelli

Stefano Duma

Ettore Gorini

Alessandra Stellacci

Davide Fiore Bavaro

Lucia Diella

Annalisa Saracino

Alessandro DellErba

Silvio Tafuri

Affiliations

Soon will be listed here.

Abstract

Introduction: The aim of this study was to examine the type of compensation claims for alleged medical malpractice in the field of healthcare-related infections in Italy.

Methods: It was analyzed which was the most frequent clinical context, the characteristics of the disputes established, which were the alleged damages most often complained of, which were the possibly censurable behaviors of the health professionals, and which were the reasons for acceptance or rejection of the request for compensation.

Results: In 90.2%, the issue questioned regarded surgical site infections. The most common pathogens involved were coagulase-negative Staphylococci (34.1%) and (24.4%). The lack or non-adherence to protocols of prophylaxis and/or prevention of healthcare-related infections was the most reported cause of acceptance of the request of compensation.

Discussion: According to our data, a stronger effort should be made in terms of risk management perspective in order to ensure the develop and application of protocols for prevention of Gram-positive healthcare-related infections and strengthen infection control and antimicrobial stewardship programs.

Citing Articles

From Guidelines to Action: Tackling Risk Factors for Surgical Site Infections.

Rizzo C, Venuto R, Tripodi P, Bartucciotto L, Ventura Spagnolo E, Nirta A Antibiotics (Basel). 2025; 14(1).

PMID: 39858326 PMC: 11763291. DOI: 10.3390/antibiotics14010040.

References

Sehulster L, Chinn R . Guidelines for environmental infection control in health-care facilities. Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). MMWR Recomm Rep. 2003; 52(RR-10):1-42. View

Tomsic I, Heinze N, Chaberny I, Krauth C, Schock B, von Lengerke T . Implementation interventions in preventing surgical site infections in abdominal surgery: a systematic review. BMC Health Serv Res. 2020; 20(1):236. PMC: 7083020. DOI: 10.1186/s12913-020-4995-z. View

Ariyo P, Zayed B, Riese V, Anton B, Latif A, Kilpatrick C . Implementation strategies to reduce surgical site infections: A systematic review. Infect Control Hosp Epidemiol. 2019; 40(3):287-300. DOI: 10.1017/ice.2018.355. View

Nutman A, Temkin E, Harbarth S, Carevic B, Ris F, Fankhauser-Rodriguez C . Personalized Ertapenem Prophylaxis for Carriers of Extended-spectrum β-Lactamase-producing Enterobacteriaceae Undergoing Colorectal Surgery. Clin Infect Dis. 2019; 70(9):1891-1897. DOI: 10.1093/cid/ciz524. View

Bode L, Kluytmans J, Wertheim H, Bogaers D, Vandenbroucke-Grauls C, Roosendaal R . Preventing surgical-site infections in nasal carriers of Staphylococcus aureus. N Engl J Med. 2010; 362(1):9-17. DOI: 10.1056/NEJMoa0808939. View

Humphreys H, Becker K, Dohmen P, Petrosillo N, Spencer M, van Rijen M . Staphylococcus aureus and surgical site infections: benefits of screening and decolonization before surgery. J Hosp Infect. 2016; 94(3):295-304. DOI: 10.1016/j.jhin.2016.06.011. View

Nagata K, Yamada K, Shinozaki T, Miyazaki T, Tokimura F, Tajiri Y . Effect of Antimicrobial Prophylaxis Duration on Health Care-Associated Infections After Clean Orthopedic Surgery: A Cluster Randomized Trial. JAMA Netw Open. 2022; 5(4):e226095. PMC: 9006110. DOI: 10.1001/jamanetworkopen.2022.6095. View

Wolfhagen N, Boldingh Q, de Lange M, Boermeester M, de Jonge S . Intraoperative Redosing of Surgical Antibiotic Prophylaxis in Addition to Preoperative Prophylaxis Versus Single-dose Prophylaxis for the Prevention of Surgical Site Infection: A Meta-analysis and GRADE Recommendation. Ann Surg. 2022; 275(6):1050-1057. DOI: 10.1097/SLA.0000000000005436. View

Weigelt J, Lipsky B, Tabak Y, Derby K, Kim M, Gupta V . Surgical site infections: Causative pathogens and associated outcomes. Am J Infect Control. 2009; 38(2):112-20. DOI: 10.1016/j.ajic.2009.06.010. View

10.

Norton T, Skeete F, Dubrovskaya Y, Phillips M, Bosco 3rd J, Mehta S . Orthopedic surgical site infections: analysis of causative bacteria and implications for antibiotic stewardship. Am J Orthop (Belle Mead NJ). 2014; 43(5):E89-92. View

11.

Tartari E, Weterings V, Gastmeier P, Rodriguez Bano J, Widmer A, Kluytmans J . Patient engagement with surgical site infection prevention: an expert panel perspective. Antimicrob Resist Infect Control. 2017; 6:45. PMC: 5427557. DOI: 10.1186/s13756-017-0202-3. View

12.

Marchi M, Pan A, Gagliotti C, Morsillo F, Parenti M, Resi D . The Italian national surgical site infection surveillance programme and its positive impact, 2009 to 2011. Euro Surveill. 2014; 19(21). DOI: 10.2807/1560-7917.es2014.19.21.20815. View

13.

Koek M, Hopmans T, Soetens L, Wille J, Geerlings S, Vos M . Adhering to a national surgical care bundle reduces the risk of surgical site infections. PLoS One. 2017; 12(9):e0184200. PMC: 5587118. DOI: 10.1371/journal.pone.0184200. View

14.

Jenks P, Laurent M, McQuarry S, Watkins R . Clinical and economic burden of surgical site infection (SSI) and predicted financial consequences of elimination of SSI from an English hospital. J Hosp Infect. 2013; 86(1):24-33. DOI: 10.1016/j.jhin.2013.09.012. View

15.

Sangiorgio G, Vacante M, Basile F, Biondi A . Oral and Parenteral vs. Parenteral Antibiotic Prophylaxis for Patients Undergoing Laparoscopic Colorectal Resection: An Intervention Review with Meta-Analysis. Antibiotics (Basel). 2022; 11(1). PMC: 8773268. DOI: 10.3390/antibiotics11010021. View

16.

Bull A, Worth L, Richards M . Impact of vancomycin surgical antibiotic prophylaxis on the development of methicillin-sensitive staphylococcus aureus surgical site infections: report from Australian Surveillance Data (VICNISS). Ann Surg. 2012; 256(6):1089-92. DOI: 10.1097/SLA.0b013e31825fa398. View

17.

Berrios-Torres S, Yi S, Bratzler D, Ma A, Mu Y, Zhu L . Activity of commonly used antimicrobial prophylaxis regimens against pathogens causing coronary artery bypass graft and arthroplasty surgical site infections in the United States, 2006-2009. Infect Control Hosp Epidemiol. 2014; 35(3):231-9. DOI: 10.1086/675289. View

18.

Awad S, Palacio C, Subramanian A, Byers P, Abraham P, Lewis D . Implementation of a methicillin-resistant Staphylococcus aureus (MRSA) prevention bundle results in decreased MRSA surgical site infections. Am J Surg. 2009; 198(5):607-10. DOI: 10.1016/j.amjsurg.2009.07.010. View

19.

Hoang S, Klipfel A, Roth L, Vrees M, Schechter S, Shah N . Colon and rectal surgery surgical site infection reduction bundle: To improve is to change. Am J Surg. 2018; 217(1):40-45. DOI: 10.1016/j.amjsurg.2018.07.008. View

20.

Brunner S, Liesenberg J, Fourie L, Metzger J, Scheiwiller A, Zschokke I . Implementation of a Bundle of Care in Colorectal Surgery to Reduce Surgical Site Infections Successfully at Cantonal Hospital Lucerne: Study Protocol for a Prospective Observational Study. Int J Surg Protoc. 2021; 25(1):220-226. PMC: 8462471. DOI: 10.29337/ijsp.150. View