title: Surgical site infection rates in four Mexican cities: findings of the International Nosocomial Infection Control Consortium (INICC).
abstract: From January 2005 to December 2010, we conducted a prospective cohort surveillance study on surgical site infections (SSIs) in five hospitals, all of which were members of the International Nosocomial Infection Control Consortium (INICC) in four cities in Mexico. Data were recorded from hospitalized patients using the methods and definitions of the Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC-NHSN) for SSIs. Surgical procedures (SPs) were classified into 11 types according to the ICD-9 criteria. We documented 312 SSIs, associated with 5063 SPs (5.5%; CI, 5.5-6.9). SSI rates per type of SP in these Mexican hospitals compared with the INICC and CDC-NHSN reports, respectively, include: 18.4% for ventricular shunt (vs. 12.9% vs. 5.6%); 10% for spleen surgery (vs. 5.6% vs. 2.3%); 7.3% for cardiac surgery (vs. 5.6% vs. 1.3%); 6.4% for open reduction of fracture (vs. 4.2% vs. 1.7%); 5.2% for exploratory abdominal surgery (vs. 4.1% vs. 2.0%), and 5.1% for hip prosthesis (vs. 2.6% vs. 1.3%). Compared with the CDC-NHSN, our SSIs rates were higher in 73% and similar in 27% of the analyzed types of SPs, whereas compared with INICC, rates were similar in 55% and higher in 45% of SPs. There are no data on SSI rates by surgical procedure in Mexico. Therefore, this paper represents an important advance in the knowledge of epidemiology of SSIs in Mexico that will allow us to introduce targeted interventions. This study also demonstrates that the INICC is a valuable international benchmarking tool, in addition to the CDC-NSHN, the participating hospitals of which enjoy factual advantages.
authors.affiliation: CIMA, Chihuaha, Mexico.
authors.forename: Jorge H
authors.initials: JH
authors.lastname: Portillo-Gallo
authors.affiliation: Hospital de Pediatría, Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico.
authors.forename: María G
authors.initials: MG
authors.lastname: Miranda-Novales
authors.affiliation: International Nosocomial Infection Control Consortium, Buenos Aires, Argentina. Electronic address: victor_rosenthal@inicc.org.
authors.forename: Victor D
authors.initials: VD
authors.lastname: Rosenthal
authors.affiliation: Hospital General Norte, Puebla, Mexico.
authors.forename: Marisol
authors.initials: M
authors.lastname: Sánchez
authors.affiliation: Hospital San José-Tec de Monterrey, Monterrey, Mexico.
authors.forename: Juan Jacobo
authors.initials: JJ
authors.lastname: Ayala-Gaytan
authors.affiliation: Hospital Betania, Puebla, Mexico.
authors.forename: Victor Roberto
authors.initials: VR
authors.lastname: Ortiz-Juárez
authors.affiliation: CIMA, Chihuaha, Mexico.
authors.forename: Fernando
authors.initials: F
authors.lastname: Aguilera-Almazán
authors.affiliation: CIMA, Chihuaha, Mexico.
authors.forename: Gaspar
authors.initials: G
authors.lastname: Iglesias-Miramontes
authors.affiliation: CIMA, Chihuaha, Mexico.
authors.forename: María Del Rosario
authors.initials: Mdel R
authors.lastname: Vázquez-Olivas
authors.affiliation: CIMA, Chihuaha, Mexico.
authors.forename: Alicia
authors.initials: A
authors.lastname: Sánchez-Chávez
authors.affiliation: CIMA, Chihuaha, Mexico.
authors.forename: Yolcey
authors.initials: Y
authors.lastname: Angulo-Espinoza
authors.affiliation: Hospital de Pediatría, Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico.
authors.forename: Irma
authors.initials: I
authors.lastname: Zamudio-Lugo
mesh_terms: D002947:Cities; D015331:Cohort Studies; D003906:Developing Countries; D006761:Hospitals; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology*
keywords: Developing countries; Health care-associated infection; Hospital infection; Mexico; Nosocomial infection; Surgical wound infection