The importance of surveillance of surgical site infections: results from an Italian teaching hospital

Abstract Background Healthcare-associated infections, particularly Surgical Site Infections (SSIs), impose a significant burden on healthcare systems, resulting in increased patient morbidity, prolonged hospital stays, and substantial financial costs. Although surveillance systems are essential for monitoring and reducing SSIs, their implementation and effectiveness can vary considerably across healthcare institutions. This study aims to analyse SSI patterns at Ferrara Teaching Hospital to provide valuable insights for improving monitoring protocols. Methods A retrospective study was conducted on data of Surgical Site Infection Surveillance System and Hospital Discharge Cards (HDCs) of Ferrara Teaching Hospital from 2020 to 2023. To evaluate the phenomenon, the following indicators were calculated: total SSI prevalence rate and incidence density of hospital-onset SSIs per 1.000 days of follow-up. Descriptive analysis (mean and standard deviation) was performed using STATA software. Results During the study period, an average of 5,158±301.6 surgeries were monitored annually, with surveillance coverage steadily increasing to 80.7% in 2023. The average SSI prevalence rate was 1.11±0.27, with the higher value for colon surgery (2.33±1.17), hip arthroplasty (2.27±4.54), rectal surgery (1.54±1.79) and for knee arthroplasty (1.04±0.51). Cardiac surgeries were the only procedures in which no SSIs were recorded. The overall incidence density of hospital-onset SSIs was 0.59±0.62, with higher value for caesarean section (1.40±1.67), colon surgery (1.35±1.46), rectal surgery (0.89±1.11) and knee arthroplasty (0.32±0.40). Conclusions The study shows an increasing improvement in the coverage and accuracy of SSI surveillance, confirming the effectiveness of the monitoring system. However, the findings underscore the need for targeted interventions, particularly for high-risk procedures such as colorectal and orthopedic surgeries, and caesarean sections. Key messages • Effective SSI surveillance systems are crucial for healthcare institutions to monitor and prevent surgical complications, reduce hospital stays, and optimize healthcare costs. • Regular monitoring of SSI patterns enables hospitals to identify high-risk procedures and implement targeted preventive strategies, ultimately improving patient safety and quality of care.