title: Surgical Site Infection Rates in Seven Cities in Vietnam: Findings of the International Nosocomial Infection Control Consortium.
abstract: BACKGROUND
  Surgical site infections (SSIs) are the most common healthcare-associated infections (HAI) in lower-income countries. This is the first study to report the results of surveillance on SSI stratified by surgical procedure in seven Vietnamese cities.
  
  
  METHODS
  This was a prospective, active SSI surveillance study conducted from November 2008-December 2010 in seven hospitals using the U.S. Centers for Disease Control and Prevention's National Healthcare Safety Network (CDC-NHSN) definitions and methods. Surgical procedures (SPs) were classified into 26 types according to the International Classification of Diseases Edition 9 criteria.
  
  
  RESULTS
  We recorded 241 SSIs, associated with 4,413 SPs (relative risk [RR] 5.5%; 95% confidence interval [95% CI] 4.8-6.2). The highest SSI rates were found for limb amputation (25%), colon surgery (33%), and small bowel surgery (21%). Compared with CDC-NHSN SSI report, our SSI rates were higher for the following SPs: Limb amputation (25% vs. 1.3%; RR 20.0; p = 0.001); appendix surgery (8.8% vs. 3.5%; RR 2.54; 95% CI 1.3-5.1; p = 0.001); gallbladder surgery (13.7% vs. 1.7%; RR 7.76; 95% CI 1.9-32.1; p = 0.001); colon surgery (18.2% vs. 4.0%; RR 4.56; 95% CI 2.0-10.2; p = 0.001); open reduction of fracture (15.8% vs. 3.4%; RR 4.70, 95% CI 1.5-15.2; p = 0.004); gastric surgery (7.3% vs. 1.7%; RR 4.26; 95% CI 2.2-8.4, p = 0.001); kidney surgery (8.9% vs. 0.9%; RR 10.2; 95% CI 3.8-27.4; p = 0.001); prostate surgery (5.1% vs. 0.9%; RR 5.71; 95% CI 1.9-17.4; p = 0.001); small bowel surgery (20.8% vs. 6.7%; RR 3.07; 95% CI 1.7-5.6; p = 0.001); thyroid or parathyroid surgery (2.4% vs. 0.3%; RR 9.27; 95% CI 1.0-89.1; p = 0.019); and vaginal hysterectomy (14.3% vs. 1.2%; RR 12.3; 95% CI 1.7-88.4; p = 0.001).
  
  
  CONCLUSIONS
  Our SSIs rates were significantly higher for 11 of the 26 types of SPs than for the CDC-NHSN. This study advances our knowledge of SSI epidemiology in Vietnam and will allow us to introduce targeted interventions.
authors.affiliation: 1 Bach Mai Hospital , Hanoi, Vietnam .
authors.forename: Nguyen
authors.initials: N
authors.lastname: Viet Hung
authors.affiliation: 1 Bach Mai Hospital , Hanoi, Vietnam .
authors.forename: Truong
authors.initials: T
authors.lastname: Anh Thu
authors.affiliation: 3 International Nosocomial Infection Control Consortium , Buenos Aires, Argentina .
authors.forename: Victor D
authors.initials: VD
authors.lastname: Rosenthal
authors.affiliation: 2 Viet Duc Hospital , Hanoi, Vietnam .
authors.forename: Do
authors.initials: D
authors.lastname: Tat Thanh
authors.affiliation: 1 Bach Mai Hospital , Hanoi, Vietnam .
authors.forename: Nguyen
authors.initials: N
authors.lastname: Quoc Anh
authors.affiliation: 2 Viet Duc Hospital , Hanoi, Vietnam .
authors.forename: Nguyen
authors.initials: N
authors.lastname: Le Bao Tien
authors.affiliation: 4 Ministry of Health, Hanoi, Vietnam .
authors.forename: Nguyen
authors.initials: N
authors.lastname: Ngo Quang
mesh_terms: D000328:Adult; D002947:Cities / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000453:epidemiology*; D014744:Vietnam / Q000453:epidemiology