Countries with a low Human Development Index (HDI) carry a disproportionately greater burden of surgical site infection (SSI) than countries with a middle or high HDI and might have higher rates of antibiotic resistance. This according to a prospective, international, multicenter cohort that included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any healthcare facility in any country. Countries with participating centers were stratified into high-income, middle-income, and low-income groups according to the HDI. Researchers found:

• 12,539 patients from 343 hospitals in 66 countries were included: 7,339 (58.5%) were from high-HDI countries, 3,918 (31.2%) were from middle-HDI countries, and 1,282 (10.2%) patients were from low-HDI countries.
• In total, 1,538 (12.3%) patients had SSI within 30 days of surgery.
• Incidence of SSI varied between countries with high, middle, and low HDI.
• The highest SSI incidence in each HDI group was after dirty surgery.
• After risk factor adjustment, patients in the low-HDI countries were at greatest risk of SSI.