HPR volume 16 issue 13: news (30 December 2022)
Updated 30 December 2022
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Surveillance of surgical site infections in NHS hospitals in England: 2021 to 2022
The UK Health Security Agency (UKHSA) has published the latest annual report on surveillance of surgical site infections in NHS hospitals in England.
The report summarises data submitted to the national Surgical Site Infection Surveillance Service by 184 NHS hospitals and 8 independent sector NHS treatment centres in England during the period April 2021 to March 2022.
Surveillance data for 115,796 procedures and 968 surgical site infections (SSIs) detected during inpatient stay or on readmission to hospital were submitted in 2021 to 2022. Compared to 2020 to 2021, the number of procedures submitted increased by 73%. However, the number of procedures remained 15% lower than before the coronavirus (COVID-19) pandemic (2019 to 2020), possibly reflecting the ongoing disruption to healthcare delivery during the pandemic.
NHS trusts performing surgery in any of 4 orthopaedic categories (hip replacement, knee replacement, reduction of long bone fracture and repair of neck of femur) are required to undertake surveillance of SSI for a minimum of one 3-month surveillance period per financial year. In 2020 to 2021, however, 3 eligible trusts did not meet the mandatory participation surveillance requirements, compared to 11 trusts in the previous year. Trust-level SSI risk results for mandatory orthopaedic categories can be found as supplementary tables accompanying the main report Surgical site infections surveillance service: NHS trust tables 2020 to 2022.
The annual report presents SSI risk benchmarks for each of 17 surgical categories, trends in annual SSI incidence and variation among participating hospitals. It also includes risk-stratified SSI incidence.
Key findings were that:
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10-year trends in the annual inpatient and readmission SSI risk varied by surgical category – among the 10 categories assessed, 6 saw increases in SSI risk from the previous year
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the largest decrease in SSI risk was for large bowel surgery (from 10.5% to 7.9%), reaching the lowest SSI risk for that category in 10 years
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the data suggests there were more complex surgeries performed in 2021 to 2022 (similar to the previous year, 2020 to 2021) compared to pre-pandemic, as assessed by increases in American Society of Anesthesiologists (ASA) score of 3 or more, median surgery duration, median length of stay, and if multiple procedures were performed
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among SSIs with accompanying microbiology data, Enterobacterales continued to make up the largest proportion of causative organisms for both superficial SSIs (33.1%) and deep or organ and space SSIs (30.1%)
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4 trusts were identified as high outliers for the mandatory surveillance categories (one in each category) in 2021 to 2022
Infection reports
Group A streptococcal infections: fourth update on seasonal activity in England, 2022 to 2023.