Syracuse

Impact of participation in a surgical site infection surveillance network: results from a large international cohort study

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Abbas, Mohamed | de Kraker, M.E.A. | Aghayev, E. | Astagneau, Pascal | Aupée, M. | Behnke, M. | Bull, A. | Choi, H.J. | de Greeff, S.C. | Elgohari, S. | Gastmeier, P. | Harrison, W. | Koek, M.B.G. | Lamagni, T. | Limon, E. | Løwer, H.L. | Lyytikäinen, O. | Marimuthu, K. | Marquess, J. | Mccann, R. | Prantner, I. | Presterl, E. | Pujol, M. | Reilly, J. | Roberts, C. | Segagni Lusignani, L. | Si, D. | Szilágyi, E. | Tanguy, J. | Tempone, S. | Troillet, N. | Worth, L.J. | Pittet, D. | Harbarth, S.

Edité par CCSD ; WB Saunders -

International audience. BackgroundSurveillance of surgical site infections (SSIs) is a core component of effective infection control practices, though its impact has not been quantified on a large scale.AimTo determine the time-trend of SSI rates in surveillance networks.MethodsSSI surveillance networks provided procedure-specific data on numbers of SSIs and operations, stratified by hospitals' year of participation in the surveillance, to capture length of participation as an exposure. Pooled and procedure-specific random-effects Poisson regression was performed to obtain yearly rate ratios (RRs) with 95% confidence intervals (CIs), and including surveillance network as random intercept.FindingsOf 36 invited networks, 17 networks from 15 high-income countries across Asia, Australia and Europe participated in the study. Aggregated data on 17 surgical procedures (cardiovascular, digestive, gynaecological-obstetrical, neurosurgical, and orthopaedic) were collected, resulting in data concerning 5,831,737 operations and 113,166 SSIs. There was a significant decrease in overall SSI rates over surveillance time, resulting in a 35% reduction at the ninth (final) included year of surveillance (RR: 0.65; 95% CI: 0.63–0.67). There were large variations across procedure-specific trends, but strong consistent decreases were observed for colorectal surgery, herniorrhaphy, caesarean section, hip prosthesis, and knee prosthesis.ConclusionIn this large, international cohort study, pooled SSI rates were associated with a stable and sustainable decrease after joining an SSI surveillance network; a causal relationship is possible, although unproven. There was heterogeneity in procedure-specific trends. These findings support the pivotal role of surveillance in reducing infection rates and call for widespread implementation of hospital-based SSI surveillance in high-income countries.

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