Superficial incisional SSI |
Infection occurs within 30 days after any NHSN operative procedure (where day 1 = the procedure date) |
and |
Infection involves only skin or subcutaneous tissue of the incision |
and at least one of the following: |
- Purulent drainage, with or without laboratory confirmation, from the superficial incision.
|
- Organism(s) are identified from an aseptically obtained specimen from the superficial incision or subcutaneous tissue by a culture or non-culture-based microbiologic testing method, which is performed for purposes of clinical diagnosis or treatment.
|
- At least one of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness, or heat and superficial incision is deliberately opened by a surgeon, physician, or physician designee, unless incision is culture-negative.
|
- Diagnosis of superficial incisional SSI by the surgeon, physician, or physician designee.
|
Do not report the following conditions as SSI: |
- Diagnosis/treatment of cellulitis (redness/warmth/swelling) by itself.
|
- A stitch abscess alone (minimal inflammation and discharge confined to the points of suture penetration).
|
- A localized stab wound or pin site infection; depending on the depth, these infections might be considered either a skin or soft tissue infection.
|
NOTE: Specific criteria are used for identifying infected episiotomy and circumcision sites and burn wounds. |
Deep incisional SSI |
Infection occurs within 30 days (eg, carotid endarterectomy, liver transplant) or 90 days (eg, breast surgery, herniorrhaphy) after the NHSN operative procedure (where day 1 = the procedure date) |
and |
Infection involves deep soft tissues (eg, fascial and muscle layers) of the incision |
and at least one of the following: |
- Purulent drainage from the deep incision but not from the organ/space component of the surgical site.
|
- A deep incision spontaneously dehisces or is deliberately opened by a surgeon, physician, or physician designee when the patient has at least one of the following signs or symptoms: fever (>38°C), localized pain, or tenderness and organism(s) are identified from the deep soft tissues of the incision by a culture or non-culture-based microbiologic testing method, which is performed for purposes of clinical diagnosis or treatment.
|
- An abscess or other evidence of infection involving the deep incision is found on gross anatomical or histopathologic exam, or imaging test.
|
NOTES: |
- Report infection that involves both superficial and deep incision sites as deep incisional SSI.
|
- Report an organ/space SSI that drains through the incision as a deep incisional SSI.
|
Organ/space SSI |
Infection occurs within 30 days (eg, carotid endarterectomy, liver transplant) or 90 days (eg, breast surgery, herniorrhaphy) after the NHSN operative procedure (where day 1 = the procedure date) |
and |
Infection involves any part of the anatomy (eg, organs or spaces), other than the incision, which was opened or manipulated during an operation and at least one of the following: |
- Purulent drainage from a drain that is placed through a stab wound¶. If the area around a stab wound becomes infected, it is not an SSI. It is considered a skin or soft tissue infection, depending on its depth into the organ/space.
|
- Organism(s) are identified from fluid or tissue in the organ/space by a culture or non-culture based microbiologic testing method which is performed for purposes of clinical diagnosis or treatment.
|
- An abscess or other evidence of infection involving the organ/space that is detected on gross anatomical or histopathologic exam, or imaging test evidence suggestive of infection.
|
and |
Meets at least one criterion for a specific organ/space infection site. |