National Healthcare Safety Network (NHSN)

New England Baptist Hospital opposes the updated 2026 NHSN definition for deep incisional SSIs because it captures noninfectious cases like hematomas and seromas. They argue this increases reporting burdens and costs while artificially inflating standardized infection ratios (SIRs), and they request an edit for the 2027 requirements.

Representatives from Providence Health and Services argue that the current CDC/NHSN surveillance criteria for surgical site infections (SSIs) are too sensitive and lack specificity, leading to false positives. They request revisions to the criteria to include explicit exclusions for non-infectious processes, require infectious indications for "deliberate opening" of incisions, and add anatomic/causal plausibility filters to the surveillance window.

Representatives from Providence Health and Services argue that the current CDC/NHSN surveillance criteria for surgical site infections (SSIs) are too sensitive and lack specificity, leading to false positives. They request revisions to the criteria to include explicit exclusions for non-infectious processes, require infectious indications for "deliberate openings," and add anatomic/causal plausibility filters to the surveillance window.

Dr. Jason Kuhl, Chief Medical Officer at Providence Medford Medical Center, argues that the current NHSN Deep Incisional SSI surveillance definition is too broad and captures non-infectious complications. He requests revisions to the criteria to improve specificity by requiring objective markers of infection or excluding non-infectious clinical reasons for antibiotic use and surgical re-access.

Dr. Jason Kuhl of Providence Medford Medical Center argues that including uncorroborated patient-reported symptoms in NHSN healthcare-associated infection (HAI) surveillance definitions leads to inaccurate data and unnecessary clinical interventions. He recommends revising the definitions to require clinical corroboration by a licensed healthcare provider to ensure data integrity and reliability.

The commenters from Beth Israel Deaconess Medical Center and New England Baptist Hospital oppose the updated 2026 NHSN definition for deep incisional surgical site infections (SSIs). They argue that the current definition captures noninfectious cases like hematomas and seromas, which increases reporting burdens, costs, and artificially inflates standardized infection ratios (SIRs).

The commenter, identifying as an NHSN user, supports the inclusion of risk-adjusted calculations or the exclusion of HIPEC procedures from CMS reportable data metrics. They argue that because HIPEC significantly increases the risk of surgical site infections (SSI), including these cases in standard metrics without adjustment falsely skews hospital performance data and impacts reimbursement.

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.

Jenny Mayo, a Senior Infection Preventionist at Providence Alaska Medical Center, requests that the NHSN reclassify vaginal cuff infections (VCUFF) from organ/space surgical site infections to superficial incisional infections. She argues that the current classification is anatomically inconsistent and leads to an overestimation of organ-space SSIs, suggesting that standardization would improve data accuracy and clinical relevance.

Amy Kilroy of Providence Alaska Medical Center requests that the NHSN revise its surveillance definitions to require clinical corroboration by a licensed healthcare provider for patient-reported signs or symptoms. The commenter argues that relying on uncorroborated patient reports can lead to inaccurate data, misclassification of infections, and unnecessary clinical interventions.