European surveillance of surgical site infections (HELICS-SSI), 2004–2005

Abstract number: 1733_1441

Wilson J., Suetens C., Ramboer I., Fabry for the HELICS-SSI working group J.

Introduction: Surgical site infections (SSI) account for up to 26% of healthcare associated infection (HCAI) and cause considerable morbidity. There is a perception that the risk of acquiring HCAI varies between countries because of different standards in infection control practice. The Hospitals in Europe Link for Infection Control through Surveillance (HELICS) has formed a `network of networks' enabling data from hospitals contributing to national surveillance networks to also be submitted to the HELICS database. This database provides an opportunity to evaluate inter-country differences in rates and explore the problems associated with making such comparisons.

Methods: HELICS SSI surveillance is targeted at 7 defined groups of procedures. A standard protocol is used by partner countries to collect a defined set of demographic and operation data on all patients undergoing an eligible procedure ( Additional data is provided on those that subsequently develop an SSI that meets the case-definition.

Results: Data on a total of 255 999 operations were received from 15 countries from 2004 to 2005 (641 hospitals in 2004, 776 hospitals in 2005). The coverage of national networks varies and hence a considerable proportion of the HELICS dataset comprises data from countries with well-established networks (41% from Germany, 24% England and 15% France). All countries submitted data on hip prosthesis Rates of SSI are conventionally expressed as a cumulative incidence. However, there are important differences between countries in the use and intensity of post-discharge surveillance and length of post-operative inpatient stay. In hip prosthesis the length of postoperative stay varies from 7 to 14 days and therefore incidence density of SSI/1000 post-operative inpatient days is a more valid measure for making inter-country comparisons (see Figure 1). The incidence density can only be calculated when the discharge date is known. Despite the standard HELICS protocol, there is evidence of differences in interpretation of case definitions and sensitivity of case finding that need to be taken into account when making comparisons.

Figure 1. Incidence density of surgical site infections/1000 post-op inpatient days in HPRO (+95% CI) by country, HELICS-SSI, cumulative data for 2004–2005.

Conclusions: The HELICS network represents a unique opportunity to measure the occurrence of clinically defined HCAI across European countries using standard definitions of infection, methods of data collection and analysis. The data shows inter-country differences in rates of SSI but also provides evidence of variation in methodology that needs to be considered when comparing rates.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Location: ICC, Munich, Germany
Presentation type:
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