Bundled Interventions to Reduce Surgical Site Infections Are Effective and Urgently Needed | Infectious Diseases | JAMA Network Open | JAMA Network
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Invited Commentary
Infectious Diseases
March 27, 2020

Bundled Interventions to Reduce Surgical Site Infections Are Effective and Urgently Needed

Author Affiliations
  • 1Section of Acute Care Surgery, Department of Surgery, Stanford University, Stanford, California
JAMA Netw Open. 2020;3(3):e201895. doi:10.1001/jamanetworkopen.2020.1895

The study by Loftus et al1 is an important addition to the literature supporting bundled infection prevention interventions to reduce the burden of surgical site infections (SSIs). The authors prospectively randomized patients undergoing a heterogeneous mix of surgical procedures to receive a standardized perioperative infection prevention bundle vs existing standard of care and followed patients for 60 days. The study was terminated early because it was found to be successful at interim analysis—among patients receiving the prevention bundle, perioperative transmission events of Staphylococcus aureus and the number of SSIs decreased significantly. This was despite the intervention group being composed of patients who were older and more seriously ill than those in the control group. Notably, Loftus et al1 confirmed that increased perioperative transmission events led to increased SSIs, with a perioperative transmission event increasing the relative risk of SSI 6-fold. The authors concluded that adopting a bundled package of interventions designed to diminish the reservoir of infectious pathogens in the perioperative setting decreases transmission events and SSIs.

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