Additional file 2 of Association between perioperative prophylaxis with cefuroxime plus metronidazole or amoxicillin/clavulanic acid and surgical site infections in paediatric uncomplicated appendectomy: a Swiss retrospective cohort study

Additional file 2: STROBE Statement

Additional file 1 of Association between perioperative prophylaxis with cefuroxime plus metronidazole or amoxicillin/clavulanic acid and surgical site infections in paediatric uncomplicated appendectomy: a Swiss retrospective cohort study

Additional file 1: eAppendix

Additional file 1 of Association between the introduction of a national targeted intervention program and the incidence of surgical site infections in Swiss acute care hospitals

Additional file 1. Supplementary Information

Lez X

<div><p>Objective</p><p>Although surgical-site infection (SSI) rates are advocated as a major evaluation criterion, the reproducibility of SSI diagnosis is unknown. We assessed agreement in diagnosing SSI among specialists involved in SSI surveillance in Europe.</p><p>Methods</p><p>Twelve case-vignettes based on suspected SSI were submitted to 100 infection-control physicians (ICPs) and 86 surgeons in 10 European countries. Each participant scored eight randomly-assigned case-vignettes on a secure online relational database. The intra-class correlation coefficient (ICC) was used to assess agreement for SSI diagnosis on a 7-point Likert scale and the kappa coefficient to assess agreement for SSI depth on a three-point scale.</p><p>Results</p><p>Intra-specialty agreement for SSI diagnosis ranged across countries and specialties from 0.00 (95%CI, 0.00–0.35) to 0.65 (0.45–0.82). Inter-specialty agreement varied from 0.04 (0.00–0.62) in to 0.55 (0.37–0.74) in Germany. For all countries pooled, intra-specialty agreement was poor for surgeons (0.24, 0.14–0.42) and good for ICPs (0.41, 0.28–0.61). Reading SSI definitions improved agreement among ICPs (0.57) but not surgeons (0.09). Intra-specialty agreement for SSI depth ranged across countries and specialties from 0.05 (0.00–0.10) to 0.50 (0.45–0.55) and was not improved by reading SSI definition.</p><p>Conclusion</p><p>Among ICPs and surgeons evaluating case-vignettes of suspected SSI, considerable disagreement occurred regarding the diagnosis, with variations across specialties and countries.</p></div

Distribution of scores assigned by infection control physicians and surgeons before reading the definitions of surgical site infections, on a 7-point Likert scale, in each of the ten European countries.

<p>SD, standard deviation; IQR, interquartile range; min, minimum; max, maximum.</p

Overall assessment of agreement about surgical site infection depth within and across 10 European countries.

a<p>SSI Depth was scored on a 4-point scale: 1, no SSI in vignettes with scores lower than 4 on the 7-point Likert scale for SSI diagnosis; 2, superficial SSI; 3, uncertainty about SSI diagnosis; 4, deep/organ space SSI in vignettes scored 4 or more on the 7-point Likert scale for SSI diagnosis.</p>b<p>SSI Depth not scored because infection scores were 3 or less.</p