SNSF project Watussi: Understanding the Drivers of Surgical Site Infection: Investigating and Modeling the Swissnoso Surveillance Data, 2018 - 2022

Objectives and organization

The research project Watussi – financed by the Swiss National Science Foundation SNSF –  proposed to investigate the national surveillance data on surgical site infections (SSI) and enrich this dataset with additional information in order to allow correlation analyses. Originally, 3 aims with overall 5 objectives were formulated. First, a descriptive epidemiological study of SSI in Switzerland. Second, correlational analyses of SSI rates with A) surveillance thoroughness, B) operating room ventilation, and C) the operating room personnel’s subjective safety climate. Third, a mathematical model of SSI pathogenesis.

For this purpose, a large team of researchers from several organizations was assembled consisting of medical doctors, nurses, statisticians, ventilation engineers, patient safety specialists, and a physicist with expertise in modeling.

Principal Investigator: Prof. Dr. Jonas Marschall, University Hospital of Bern, Department of Infectious Diseases

Project Partners:

• Prof. Andreas Widmer, University Hospital Basel, Infectious Diseases, Hospital Epidemiology
• Prof. Nicolas Troillet, Central Institute of Valais Hospitals
• Prof. Marcel Zwahlen, Institute of Social and Preventive Medicine (ISPM)
• Prof. David Schwappach, Institute of Social and Preventive Medicine (ISPM), until 03/2022 Director Patient Safety Switzerland
• Dr. Benoît Sicre, Lucerne University of Applied Sciences and Arts, Engineering and Architecture

Collaborators: Dr. Andrew Atkinson, Dr. Lauro Damonti, Dr. Philipp Jent, Judith Maag, MA, MSc, MPH, Dr. Vanja Piezzi, Dr. Yvonne Pfeiffer, Dr. Luisa Salazar Vizcaya, Dr. Bernard Surial

Publications / Presentations

Pfeiffer Y, Atkinson A, Maag J, Lane MA, Schwappach D, Marschall J. Are cross-sectional safety climate survey results in operating room staff associated with the surgical site infection rates in Swiss hospitals? BMJ Open. 2023 Apr 19;13(4):e066514.

Damonti L, Atkinson A, Fontannaz L, Burnham JP, Jent P, Troillet N, Widmer A, Marschall J; for Swissnoso; National Center for Infection Control. Influence of environmental temperature and heatwaves on surgical site infection after hip and knee arthroplasty: a nationwide study. J Hosp Infect. 2023 Mar 30;135:125-131.

Pfeiffer Y, Atkinson A, Maag J, Lane MA, Schwappach DLB, Marschall J. Preventing Surgical Site Infections: Are Safety Climate Level and Its Strength Associated With Self-reported Commitment To, Subjective Norms Toward, and Knowledge About Preventive Measures? J Patient Saf. 2023 Feb 23.

Surial B, Atkinson A, Külpmann R, Brunner A, Hildebrand K, Sicre B, Troillet N, Widmer A, Rolli E, Maag J, Marschall J. Better Operating Room Ventilation as Determined by a Novel Ventilation Index is Associated With Lower Rates of Surgical Site Infections. Ann Surg. 2022 Nov 1;276(5):e353-e360.
Swissnoso Editorial

Piezzi V, Atkinson A, Jent P, Troillet N, Zwahlen M, Widmer A, Marschall J. Focusing on the follow-up for detecting surgical site infections after total joint arthroplasty and cardiac surgery: A cohort study from the Swiss national surveillance system, 2009-2018. Infect Control Hosp Epidemiol. 2022 May 5:1-2.

Atkinson A, Eisenring MC, Troillet N, Kuster SP, Widmer A, Zwahlen M, Marschall J. Surveillance quality correlates with surgical site infection rates in knee and hip arthroplasty and colorectal surgeries: A call to action to adjust reporting of SSI rates. Infect Control Hosp Epidemiol. 2021 Feb 18:1-7.
Swissnoso Kommentar.

Buetti N, Atkinson A, Troillet N, Eisenring MC, Zwahlen M, Kuster SP, Widmer A, Marschall J. Risk factors for surgical site infection after total joint arthroplasty: data from the Swiss national surveillance system. IDWeek San Francisco, 2018.