Comment from Mayo, Jenny
Jenny MayoSupportIndividual
Summary: The commenter, likely a healthcare professional, proposes modifying the surveillance criteria for superficial incisional Surgical Site Infections (SSI). They argue that requiring symptoms (like swelling or pain) when skin commensals are isolated would improve the correlation between surveillance data and actual clinical outcomes.
Post operative patients often seek care from outpatient clinics for minor complaints, included redness, irritation from dressing, uncomplicated cellulitis that often result in a swab of the skin site being sent for culture. Even with skin cleansing, low amounts of common commensals from the skin microbiotia are note eradicated and may still be isolated in low amounts. Superficial Incisional SSI criteria b allows for the isolation of any organism in any amount from such a specimen to be used for superficial incisional SSI. This is a low sensitivity criteria from a site expected to be heavily colonized with a variety of organisms form the coagulase negative Staphylococci group, and viridians group streptococci, Corynebacterium, Cutibacterium, etc. I would propose of modication of this criteria to require a symptom associated with infection when the organism required is a skin commensal organism (e.g. swelling, pain). This would increase the correlation of a clinical infection to the surveillance definitions. The closer definitions are to matching clinical outcomes, the more valuable the data obtained can be to assess interventions and drive change. Thank you for your consideration of modifying this criteria to improve surveillance and SSI prevention.