Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University Medical Center, Durham, North Carolina.
Division of Infectious Diseases and International Health, Department of Medicine, Duke University School of Medicine, Duke University, Durham, North Carolina.
Infect Control Hosp Epidemiol. 2023 Apr;44(4):610-615. doi: 10.1017/ice.2022.135. Epub 2022 Jul 18.
Sparse recent data are available on the epidemiology of surgical site infections (SSIs) in community hospitals. Our objective was to provide updated epidemiology data on complex SSIs in community hospitals and to characterize trends of SSI prevalence rates over time.
Retrospective cohort study.
SSI data were collected from patients undergoing 26 commonly performed surgical procedures at 32 community hospitals in the southeastern United States from 2013 to 2018. SSI prevalence rates were calculated for each year and were stratified by procedure and causative pathogen.
Over the 6-year study period, 3,561 complex (deep incisional or organ-space) SSIs occurred following 669,467 total surgeries (prevalence rate, 0.53 infections per 100 procedures). The overall complex SSI prevalence rate did not change significantly during the study period: 0.58 of 100 procedures in 2013 versus 0.53 of 100 procedures in 2018 (prevalence rate ratio [PRR], 0.84; 95% CI, 0.66-1.08; = .16). Methicillin-sensitive (MSSA) complex SSIs (n = 480, 13.5%) were more common than complex SSIs caused by methicillin-resistant (MRSA; n = 363, 10.2%).
The complex SSI rate did not decrease in our cohort of community hospitals from 2013 to 2018, which is a change from prior comparisons. The reason for this stagnation is unclear. Additional research is needed to determine the proportion of or remaining SSIs that are preventable and what measures would be effective to further reduce SSI rates.
关于社区医院外科部位感染（SSI）的流行病学，目前数据较为稀少。本研究旨在提供社区医院复杂 SSI 的最新流行病学数据，并分析 SSI 发生率随时间的变化趋势。
回顾性队列研究。
从 2013 年至 2018 年，在美国东南部的 32 家社区医院的 26 种常见手术中收集 SSI 数据。计算了每年的 SSI 发生率，并按手术类型和病原体进行分层。
在 6 年的研究期间，669467 例手术中有 3561 例发生了复杂（深部切口或器官间隙）SSI（发生率为每 100 例手术中 0.53 例感染）。在研究期间，总体复杂 SSI 发生率没有显著变化：2013 年为每 100 例手术 0.58 例，2018 年为每 100 例手术 0.53 例（发生率比 [PRR]，0.84；95%置信区间，0.66-1.08；P =.16）。耐甲氧西林金黄色葡萄球菌（MSSA）引起的复杂 SSI（n = 480，13.5%）比耐甲氧西林金黄色葡萄球菌（MRSA；n = 363，10.2%）引起的复杂 SSI 更为常见。
从 2013 年到 2018 年，我们的社区医院队列中复杂 SSI 发生率没有下降，这与之前的比较有所不同。这种停滞的原因尚不清楚。需要进一步研究以确定可预防的 SSI 比例以及哪些措施可有效进一步降低 SSI 发生率。
