Staphylococcus aureus surgical site infection rates in 5 European countries

Abstract

Objective To determine the overall and procedure-specific incidence of surgical site infections (SSI) caused by Staphylococcus aureus (S. aureus) as well as risk factors for such across all surgical disciplines in Europe. Methods This is a retrospective cohort of patients with surgical procedures performed at 14 European centres in 2016, with a nested case–control analysis. S. aureus SSI were identified by a semi-automated crossmatching bacteriological and electronic health record data. Within each surgical procedure, cases and controls were matched using optimal propensity score matching. Results A total of 764 of 178 902 patients had S. aureus SSI (0.4%), with 86.0% of these caused by methicillin susceptible and 14% by resistant pathogens. Mean S. aureus SSI incidence was similar for all surgical specialties, while varying by procedure. Conclusions This large procedure-independent study of S. aureus SSI proves a low overall infection rate of 0.4% in this cohort. It provides proof of principle for a semi-automated approach to utilize big data in epidemiological studies of healthcare-associated infections. Trials registration The study was registered at clinicaltrials.gov under NCT03353532 (11/2017).

Individual and institutional predisposing factors of MRSA surgical site infection and outcomes—a retrospective case-control-study in 14 European high-volume surgical centres

“…This analysis was based on the dataset of the SALT study. 7 , 8 SALT is a case-control study, comprising microbiologically proven SA SSI cases and matched uninfected controls without documented clinical or microbiological evidence of SSI (Table S2 , available as Supplementary data at JAC-AMR Online) nested within a retrospective multinational, multicentre cohort of 178 903 patients undergoing invasive surgery at participating centres in France, Germany, Italy, Spain and the UK in 2016. Participating centres were Central University Hospital of Limoges, Central Regional University Hospital of Tours, Central Departmental Hospital of Vendée in France; University Hospitals of Munich, Bonn, Jena and Cologne in Germany; Hospital Clinic of Barcelona, General University Hospital Gregorio Marañón, Hospital del Mar Medical Research Institute, La Fe University and Polytechnic Hospital, University Hospital Ramón y Cajal Madrid in Spain; Central Manchester University Hospitals in UK and University of Udine and Santa Maria Misericordia University Hospital in Italy.…”

“…The Europe-wide SALT ( Staphylococcus aureus surgical site infection rates in five European countries) study recently analysed overall S. aureus SSI incidence in France, Germany, Italy, Spain and the UK for all invasive surgeries at 14 high-volume centres, defined as executing more than 10 000 procedures annually. 7 Given the impact of MRSA on SSI outcomes, we report an in-depth subgroup analysis of patients with MRSA SSI within the SALT patient cohort. We evaluate patient and institutional determinants of MRSA incidence as well as overall and country-specific infection rates.…”