Implementation of surgical site infection surveillance in low- and middle-income countries: A position statement for the International Society for Infectious Diseases.
- Mehtar S Infection Control Africa Network, Cape Town, South Africa.
- Wanyoro A Department of Obstetrics and Gynecology, Kenyatta University, Nairobi, Kenya.
- Ogunsola F Infection Control African Network, College of Medicine, University of Lagos, Nigeria.
- Ameh EA Division of Paediatric Surgery National Hospital, Abuja, Nigeria.
- Nthumba P Clinical Epidemiologist and Plastic Surgeon, AIC Kijabe Hospital, and GCB, University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland. Electronic address: nthumba@gmail.com.
- Kilpatrick C World Surgical Infection Society, United States.
- Revathi G Microbiology Laboratory, Aga Khan University Hospital, Nairobi, Kenya.
- Antoniadou A Department of Intensive Care, 'Gennimatas' Hospital, Thessaloniki, Greece.
- Giamarelou H Hygeia General Hospital, Athens, Greece.
- Apisarnthanarak A Division of Infectious Diseases, Thammasat University Hospital, Pratum Thani, Thailand.
- Ramatowski JW International Federation for Infectious Diseases, Boston, United States.
- Rosenthal VD Nosocomial Infection Control Consortium, Buenos Aires, Argentina.
- Storr J Consultant with S2 Incorporated, Geneva, Switzerland.
- Osman TS Global Disease Detection, US Naval Medical Research Unit 3, Cairo, Egypt.
- Solomkin JS World Surgical Infection Society, Cincinnati, United States. Electronic address: solomkjs@uc.edu.
- 2020-07-27
Published in:
- International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases. - 2020
English
Surgical site infection (SSI) rates in low- and middle-income countries (LMICs) range from 8 to 30% of procedures, making them the most frequent healthcare-acquired infection (HAI) with substantial morbidity, mortality, and economic impacts. Presented here is an approach to surgical site infection prevention based on surveillance and focused on five critical areas identified by international experts. These five areas include 1. Collecting valid, high-quality data; 2. Linking HAIs to economic incapacity, underscoring the need to prioritize infection prevention activities; 3. Implementing SSI surveillance within infection prevention and control (IPC) programs to enact structural changes, develop procedural skills, and alter healthcare worker behaviors; 4. Prioritizing IPC training for healthcare workers in LMICs to conduct broad-based surveillance and to develop and implement locally applicable IPC programs; and 5. Developing a highly accurate and objective international system for defining SSIs, which can be translated globally in a straightforward manner. Finally, we present a clear, unambiguous framework for successful SSI guideline implementation that supports developing sustainable IPC programs in LMICs. This entails 1. Identifying index operations for targeted surveillance; 2. Identifying IPC "champions" and empowering healthcare workers; 3. Using multimodal improvement measures; 4. Positioning hand hygiene programs as the basis for IPC initiatives; 5. Use of telecommunication devices for surveillance and healthcare outcome follow-ups. Additionally, special considerations for pediatric SSIs, antimicrobial resistance development, and antibiotic stewardship programs are addressed.
- Language
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- English
- Open access status
- gold
- Identifiers
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- DOI 10.1016/j.ijid.2020.07.021
- PMID 32712427
- Persistent URL
- https://folia.unifr.ch/global/documents/222531
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