title: Epidemiology of Surgical Site Infection in a Community Hospital Network.
abstract: OBJECTIVE
  To describe the epidemiology of complex surgical site infection (SSI) following commonly performed surgical procedures in community hospitals and to characterize trends of SSI prevalence rates over time for MRSA and other common pathogens
  
  
  METHODS
  We prospectively collected SSI data at 29 community hospitals in the southeastern United States from 2008 through 2012. We determined the overall prevalence rates of SSI for commonly performed procedures during this 5-year study period. For each year of the study, we then calculated prevalence rates of SSI stratified by causative organism. We created log-binomial regression models to analyze trends of SSI prevalence over time for all pathogens combined and specifically for MRSA.
  
  
  RESULTS
  A total of 3,988 complex SSIs occurred following 532,694 procedures (prevalence rate, 0.7 infections per 100 procedures). SSIs occurred most frequently after small bowel surgery, peripheral vascular bypass surgery, and colon surgery. Staphylococcus aureus was the most common pathogen. The prevalence rate of SSI decreased from 0.76 infections per 100 procedures in 2008 to 0.69 infections per 100 procedures in 2012 (prevalence rate ratio [PRR], 0.90; 95% confidence interval [CI], 0.82-1.00). A more substantial decrease in MRSA SSI (PRR, 0.69; 95% CI, 0.54-0.89) was largely responsible for this overall trend.
  
  
  CONCLUSIONS
  The prevalence of MRSA SSI decreased from 2008 to 2012 in our network of community hospitals. This decrease in MRSA SSI prevalence led to an overall decrease in SSI prevalence over the study period.
authors: 1Department of Medicine,Division of Infectious Diseases,Duke University Medical Center,Durham,North Carolina.
authors: Arthur W
authors: AW
authors: Baker
authors: 1Department of Medicine,Division of Infectious Diseases,Duke University Medical Center,Durham,North Carolina.
authors: Kristen V
authors: KV
authors: Dicks
authors: 1Department of Medicine,Division of Infectious Diseases,Duke University Medical Center,Durham,North Carolina.
authors: Michael J
authors: MJ
authors: Durkin
authors: 4Department of Epidemiology,University of North Carolina Gillings School of Global Public Health,Chapel Hill,North Carolina.
authors: David J
authors: DJ
authors: Weber
authors: 1Department of Medicine,Division of Infectious Diseases,Duke University Medical Center,Durham,North Carolina.
authors: Sarah S
authors: SS
authors: Lewis
authors: 1Department of Medicine,Division of Infectious Diseases,Duke University Medical Center,Durham,North Carolina.
authors: Rebekah W
authors: RW
authors: Moehring
authors: 1Department of Medicine,Division of Infectious Diseases,Duke University Medical Center,Durham,North Carolina.
authors: Luke F
authors: LF
authors: Chen
authors: 1Department of Medicine,Division of Infectious Diseases,Duke University Medical Center,Durham,North Carolina.
authors: Daniel J
authors: DJ
authors: Sexton
authors: 1Department of Medicine,Division of Infectious Diseases,Duke University Medical Center,Durham,North Carolina.
authors: Deverick J
authors: DJ
authors: Anderson
mesh_terms: D003428:Cross Infection / Q000453:epidemiology*; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D015999:Multivariate Analysis; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D015144:Southeastern United States / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013530:Surgical Wound Infection / Q000453:epidemiology*