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

      Abbas, M; de Kraker, M E A; Aghayev, E; Astagneau, P; Aupee, 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 (2018-12-07)
      Surveillance 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. To determine the time-trend of SSI rates in surveillance networks. SSI 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. Of 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.