Surgical Site Infection Rates in Four Cities in Brazil: Findings of the International Nosocomial Infection Control Consortium

Abstract

Background: There are no data on surgical site infection (SSI) rates stratified by surgical procedures (SPs) in Brazil, and our objective was to report such rates. Methods: From January 2005 to December 2010 we conducted a surveillance study on SSIs in four hospital members of the International Nosocomial Infection Control Consortium (INICC) in four Brazilian cities. We applied the U.S. Centers for Disease Control and Prevention's National Healthcare Safety Network's (CDC-NHSN's) surveillance methods. Surgical procedures were classified into following types following International Classification of Diseases (ICD-9) criteria. Results: We recorded 349 SSIs, associated to 61,863 SPs (0.6%; [CI], 0.5-0.6). SSI rates per type of SP were compared with INICC and CDC-NHSN reports, respectively: 2.9% for cardiac surgery (vs. 5.6%, p=0.001 vs. 1.3%, p=0.001); 0.4% for cesarean section (vs. 0.7%, p=0.001 vs. 1.8%, p=0.001); 5.4% for craniotomy (vs. 4.4% p=0.447 vs. 2.6% p=0.005) and 1.1% for vaginal hysterectomy (vs. 2.0% p=0.102 vs. 0.9% p=0.499.) Conclusions: Our SSI rates were greater in two of the four analyzed types of SPs compared with CDC-NHSN, but similar to most INICC rates. These findings on the epidemiology of SSI in Brazil will enable us to introduce targeted interventions for infection control.