CDC Criteria for Surgical Site Infection

(1) incisional surgical site infections, which are further subdivided into

(1a) superficial incisional (skin and subcutaneous tissues)

(1b) deep incisional (deep soft tissue such as fascia and muscle layers)

(2) organ/space surgical site infections (any part of anatomy other than the incision opened or manipulated during an operative procedure)

These can be diagnosed by following diagnostic criteria.

 

Superficial incisional surgical site infection criteria:

(1) infection occurs at incision site within 30 days after surgery, and

(2) infection involves only skin and subcutaneous tissue of the incision, and

(3) at least one of the following:

(3a) purulent drainage from the superficial incision

(3b) organism isolated from culture of fluid or tissue from the superficial incision

(3c) surgeon deliberately opens wound and there is at least one sign or symptom (pain, tenderness, localized swelling, redness, heat), unless the wound culture is negative

(3d) diagnosis of infection by surgeon or attending physician

(4) none of the following:

(4a) stitch abscess with minimal inflammation and discharge confined to the points of suture penetration

(4b) infection of an episiotomy site

(4c) infection of a neonatal circumcision site

(4d) infected burn wound

 

Deep incisional surgical site infection criteria:

(1) infection occurs at operative site

(1a) within 30 days after surgery if no implant (nonhuman-derived foreign body that is permanently placed in the patient during surgery) is left in place,

(1b) within 1 year after surgery if an implant is left in place

(2) infection appears related to surgery, and

(3) infection involves deep soft tissue (muscle and fascial layers), and

(4) at least one of the following:

(4a) purulent drainage from the deep incision but not from the organ/space component of the surgical site

(4b) wound dehisces or is deliberately opened by surgeon when patient has fever ( > 38°C) and/or localized pain and/or tenderness, unless the wound culture is negative

(4c) an abscess or other evidence of infection involving the deep incision seen on direct examination, during surgery, by histopathologic examination or by radiologic examination

(4d) diagnosis of deep incisional surgical site infection by surgeon or attending physician

 

Organ/Space surgical site infection criteria:

(1) infection occurs

(1a) within 30 days after surgery if no implant (nonhuman-derived foreign body that is permanently placed in the patient during surgery) is left in place,

(1b) within 1 year after surgery if an implant is left in place

(2) infection appears related to surgery, and

(3) infection involves any part of anatomy other than the incision opened or manipulated during an operative procedure, and

(4) at least one of the following:

(4a) purulent drainage from a drain that is placed through a stab wound into the organ/space

(4b) organisms isolated from an aseptically obtained culture of fluid or tissue in the organ or space

(4c) an abscess or other evidence of infection involving organ or space seen on direct examination, during surgery, by histopathologic examination, or on radiologic examination

(4d) diagnosis of an organ/space surgical site infection by surgeon or attending physician

 

Specific sites of organ or space surgical site infection:

(1) arterial or venous infection

(2) breast abscess or mastitis

(3) intervertebral disc space

(4) ear, mastoid

(5) endometritis

(6) endocarditis

(7) eye, other than conjunctiva

(8) gastrointestinal tract

(9) intra-abdominal, not specified elsewhere

(10) intracranial, brain, or dural infection or abscess

(11) joint or bursa

(12) mediastinitis

(13) meningitis or ventriculitis

(14) myocarditis or pericarditis

(15) oral cavity (mouth, tongue or gums)

(16) osteomyelitis

(17) other infections of the lower respiratory tract

(18) other infections of the urinary tract

(19) other male or female reproductive tract

(20) spinal abscess without meningitis

(21) sinusitis

(22) upper respiratory tract, pharyngitis

(23) vaginal cuff

 

Classification when more than one site involved:

(1) infection involving both superficial and deep surgical incisions is classified as a deep incisional surgical site infection

(2) if an organ or space infection drains through the incision, then it is classified as a deep incisional surgical site infection