Use of health databases to deal with underreporting of surgical site infections due to suboptimal post-discharge follow-up.

This study describes a combined surveillance of surgical site infection implemented in an Italian region, which relies on integration of the specific surveillance (SIChER) with other sources and the targeted review of a small proportion of cases. Additional information on post-surgical follow-up was obtained from hospital discharge, microbiology laboratory and emergency department databases. Based on these data, 76 patients were reclassified as possible cases and revised by the health trust representatives. Eventually 45 new cases were confirmed, leading to an increase in the infection ratio from 1.13% to 1.45%. The proposed method appears to be accurate and sustainable over time.