OBJECTIVE To analyze the characteristics of global surgical site infection (SSI) outbreaks and provide references for targeted prevention and control measures.

METHODS SSI outbreak events from Jan. 1, 1990 to Dec. 31, 2023 were searched from Wanfang Med, CNKI, VIP and PubMed. Data on department distribution during the outbreak, duration, investigation methods, main causes, transmission modes, pathogen composition and outbreak outcomes were summarized for analysis.

RESULTS A total of 111 SSI outbreaks in 20 countries were identified, involving 1 382 patients and 24 deaths. The source of the outbreak was identified in 78 cases, mainly involving medical personnel in 27 cases (34.62%), hospital equipment in 19 cases (24.36%), environmental factors in 11 cases (14.10%), workflow factors in 10 cases (12.82%), hospital water factors in 7 cases (8.97%) and disinfectant factors in 4 cases (5.13%). The duration of SSI outbreaks abroad was 5.00 (1.50, 12.00) months, longer than that in China 1.00 (1.00, 2.00) month(P < 0.05). In China, the outbreaks mainly occurred in neurosurgery, cardiac surgery, orthopedics, obstetrics and general surgery, while at abroad, they mainly occurred in cardiac surgery, orthopedics, and involved multiple surgical departments. Environmental hygiene methods were adopted in up to 90.63% of cases in China. Compared with China, analytical epidemiological methods and molecular epidemiological methods were more commonly used abroad. Targeted measures and strengthened basic measures were implemented for different outbreak sources to terminate the SSI outbreaks. Pulsed-field gel electrophoresis (34 times) was a widely used molecular typing method in outbreak investigations.

CONCLUSIONS Based on the analysis of SSI outbreak characteristics and risk factors, it is necessary to strengthen medical personnel training and monitoring of special pathogens. At the same time, the epidemiological investigation capabilities of infection control professionals should be strengthened.