Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China; Department of Infectious Control, West China Hospital, Sichuan University, Chengdu, China.
Department of Infectious Control, West China Hospital, Sichuan University, Chengdu, China.
J Hosp Infect. 2024 Apr;146:206-223. doi: 10.1016/j.jhin.2023.06.004. Epub 2023 Jun 12.
Surgical site infections (SSIs) are a common type of healthcare-associated infection. We performed a literature review to demonstrate the incidence of SSIs in mainland China based on studies since 2010. We included 231 eligible studies with ≥30 postoperative patients, comprising 14 providing overall SSI data regardless of surgical sites and 217 reporting SSIs for a specific site. We found that the overall SSI incidence was 2.91% (median; interquartile range: 1.05%, 4.57%) or 3.18% (pooled; 95% confidence interval: 1.85%, 4.51%) and the SSI incidence varied remarkably according to the surgical site between the lowest (median, 1.00%; pooled, 1.69%) in thyroid surgeries and the highest (median, 14.89%; pooled, 12.54%) in colorectal procedures. We uncovered that Enterobacterales and staphylococci were the most common types of micro-organisms associated with SSIs after various abdominal surgeries and cardiac or neurological procedures, respectively. We identified two, nine, and five studies addressing the impact of SSIs on mortality, the length of stay (LOS) in hospital, and additional healthcare-related economic burden, respectively, all of which demonstrated increased mortality, prolonged LOS, and elevated medical costs associated with SSIs among affected patients. Our findings illustrate that SSIs remain a relatively common, serious threat to patient safety in China, requiring more action. To tackle SSIs, we propose to establish a nationwide network for SSI surveillance using unified criteria with the aid of informatic techniques and to tailor and implement countermeasures based on local data and observation. We highlight that the impact of SSIs in China warrants further study.
手术部位感染（SSI）是一种常见的医院获得性感染。我们进行了文献回顾，以展示 2010 年以来中国内地的 SSI 发生率。我们纳入了 231 项符合条件的研究，这些研究至少有 30 例术后患者，其中 14 项提供了无论手术部位如何的总体 SSI 数据，217 项报告了特定部位的 SSI。我们发现，总体 SSI 发生率为 2.91%（中位数；四分位距：1.05%，4.57%）或 3.18%（合并；95%置信区间：1.85%，4.51%），且 SSI 发生率根据手术部位的不同而显著不同，甲状腺手术的 SSI 发生率最低（中位数，1.00%；合并，1.69%），结直肠手术的 SSI 发生率最高（中位数，14.89%；合并，12.54%）。我们发现，肠杆菌科和葡萄球菌分别是各种腹部手术后和心脏或神经手术后与 SSI 相关的最常见微生物类型。我们确定了两项、九项和五项研究分别探讨了 SSI 对死亡率、住院时间（LOS）和额外医疗相关经济负担的影响，所有这些研究都表明 SSI 会增加受影响患者的死亡率、延长 LOS 和增加医疗费用。我们的研究结果表明，SSI 仍然是中国患者安全的一个相对常见且严重的威胁，需要采取更多措施。为了应对 SSI，我们建议建立一个使用统一标准的全国性 SSI 监测网络，借助信息学技术，并根据当地数据和观察结果制定和实施对策。我们强调，中国的 SSI 影响值得进一步研究。
