International Nosocomial Infection Control Consortium (INICC) report of health care-associated infections, data summary of 25 countries for 2014 to 2023, Surgical Site Infections Module

Victor Daniel Rosenthal; Ruijie Yin; Zhilin Jin; Safaa Abdulaziz Alkhawaja; Maria Adelia Zuñiga-Chavarria; Estuardo Salgado; Amani El-Kholy; Julio C Zuniga Moya; Priyanka Patil; Gita Nadimpalli; Rao Nadimpalli Pattabhiramarao; Dolatsinh Zala; Isabel Villegas-Mota; Bat-Erdene Ider; Nellie Tumu; Wieslawa Duszynska; Le Thi Thu Nguyet; Pravin K Nair; Ziad A Memish

doi:10.1016/j.ajic.2024.04.007

International Nosocomial Infection Control Consortium (INICC) report of health care-associated infections, data summary of 25 countries for 2014 to 2023, Surgical Site Infections Module

Am J Infect Control. 2024 Apr 9:S0196-6553(24)00167-6. doi: 10.1016/j.ajic.2024.04.007. Online ahead of print.

Authors

Victor Daniel Rosenthal¹, Ruijie Yin², Zhilin Jin², Safaa Abdulaziz Alkhawaja³, Maria Adelia Zuñiga-Chavarria⁴, Estuardo Salgado⁵, Amani El-Kholy⁶, Julio C Zuniga Moya⁷, Priyanka Patil⁸, Gita Nadimpalli⁹, Rao Nadimpalli Pattabhiramarao⁹, Dolatsinh Zala¹⁰, Isabel Villegas-Mota¹¹, Bat-Erdene Ider¹², Nellie Tumu¹³, Wieslawa Duszynska¹⁴, Le Thi Thu Nguyet¹⁵, Pravin K Nair¹⁶, Ziad A Memish¹⁷

Affiliations

¹ Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; INICC Foundation, International Nosocomial Infection Control Consortium, Miami, USA, Miami, FL, USA. Electronic address: vdr21@miami.edu.
² Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
³ Department of Infection Control, Salmaniya Medical Complex, Manama, Bahrain.
⁴ Department of Infection Control, Hospital Clinica Biblica, San Jose, Costa Rica.
⁵ Department of Infection Control, Marie Curie Hospital, Quito, Ecuador.
⁶ Department of Infection Control, Cairo University Dar Alfouad Hospital, 6th of October City, Egypt.
⁷ Department of Infection Control, Hospital Noroccidental Mario Catarino Rivas, San Pedro Sula, Honduras.
⁸ Department of Infection Control, Breach Candy Hospital Trust, Mumbai, India.
⁹ Department of Infection Control, Rao Nursing Home, Pune, India.
¹⁰ Department of Infection Control, School of Applied Science and Technology, Gujrat Technological University, Ahmedabad, India.
¹¹ Department of Infection Control, Hospital Juarez de Mexico, Mexico City, Mexico.
¹² Department of Infection Control, Intermed Hospital, Ulaanbaatar, Mongolia.
¹³ Department of Infection Control, Port Moresby General Hospital, Port Moresby, Papua New Guinea.
¹⁴ Department of Anesthesiology and Intensive Therapy, Wroclaw Medical University, Wroclaw, Poland.
¹⁵ Department of Infection Control, Thanh Nhan Hospital, Hanoi, Vietnam.
¹⁶ Department of Infection Control, Holy Spirit Hospital, Mumbai, India.
¹⁷ Department of Infection Control, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia.

PMID: 38604442
DOI: 10.1016/j.ajic.2024.04.007

Abstract

Background: Surgical site infection (SSI) rates are higher in low-resource countries (LRC) than in high-income counterparts.

Methods: Prospective cohort study using the INICC Surveillance Online System, from 116 hospitals in 75 cities across 25 Latin-American, Asian, Eastern-European, and Middle-Eastern countries: Argentina, Bahrain, Brazil, Colombia, Costa Rica, Dominican Republic, Ecuador, Egypt, Honduras, India, Kosovo, Kuwait, Lebanon, Mexico, Mongolia, Pakistan, Papua New Guinea, Philippines, Poland, Romania, Saudi Arabia, Thailand, Turkey, Venezuela, Vietnam. CDC/NHSN definitions were applied. Surgical procedures (SPs) were categorized according to the International Classification of Diseases criteria.

Results: From 2014 to 2023, we collected data on 1,251 SSIs associated with 56,617 SPs. SSI rates were significantly higher in SPs of INICC compared to CDC/NHSN data: hip prosthesis (3.68% vs 0.67%, relative risk [RR]=5.46, 95% confidence interval [CI]=3.71-8.03, P<.001), knee prosthesis (2.02% vs 0.58%, RR=3.49, 95% CI=1.87-6.49, P<.001), coronary artery bypass (4.16% vs 1.37%, RR=3.03, 95% CI=2.35-3.91, P<.001), peripheral vascular bypass (15.69% vs 2.93%, RR=5.35, 95% CI=2.30-12.48, P<.001), abdominal aortic aneurysm repair (8.51% vs 2.12%, RR=4.02, 95% CI=2.11-7.65, P<.001), spinal fusion (6.47% vs 0.70%, RR=9.27, 95% CI=6.21-13.84, P<.001), laminectomy (2.68% vs 0.72%, RR=3.75, 95% CI=2.36-5.95, P<.001), among others.

Conclusions: Elevated SSI rates in LRCs emphasize the need for effective interventions.

Keywords: Antibiotic resistance; Low-income countries; Nosocomial infection; Surgical site infection.