Risk of surgical site infection in patients undergoing orthopedic surgery

This study aimed to identify risk factors associated with surgical site infections in orthopedic surgical patients at a public hospital in Minas Gerais, Brazil, between 2005 and 2007. A historical cohort of 3,543 patients submitted to orthopedic surgical procedures. A descriptive analysis was conducted and surgical site infection incidence rates were estimated. To verify the association between infection and risk factors, the Chi-square Test was used. The strength of association of the event with the independent variables was estimated using Relative Risk, with a 95% confidence interval and p<0.05. The incidence of surgical site infection was 1.8%. Potential surgical wound contamination, clinical conditions, time and type of surgical procedure were statistically associated with infection. Identifying the association between surgical site infection and these risk factors is important and contributes to nurses’ clinical practice.

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Risk factors for surgical site infection in cardiac surgery

Acta Paulista de Enfermagem ◽

10.1590/s0103-21002012000900014 ◽

2012 ◽

Vol 25 (spe2) ◽

pp. 89-95 ◽

Cited By ~ 6

Author(s):

Quenia Cristina Gonçalves da Silva ◽

Maria Helena Barbosa

Keyword(s):

Social Sciences ◽

Risk Factors ◽

Cardiac Surgery ◽

Surgical Site Infection ◽

Descriptive Analysis ◽

Male Gender ◽

Site Infection ◽

Measures Of Association ◽

Historical Cohort ◽

The Social

OBJECTIVE: To analyze the occurrence of surgical site infection (SSI) in patients undergoing cardiac surgery in the period between July 2005, and July 2010. METHODS: A quantitative, historical cohort study that evaluated 384 patients in a public teaching hospital. The Statistical Package for the Social Sciences software was used for data analysis and for descriptive analysis, measures of association in contigency tables and logistic regression were used. RESULTS: It was found that 36 (9.4%) patients developed a SSI and that mortality occurred in 14 (38.9%). Staphylococcus aureus was the prevalent microorganism (12, 27.3%) In the multivariate analysis, the risk factors identified as predictors of SSI were male gender, intubation for more than 24 hours, and reintubation. CONCLUSION: The risk factors predictive of the occurence of SSI (p<0.05) were: male gender, reintubation, and intubation for more than 24 hours.

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Nonconcordance with Surgical Site Infection Prevention Guidelines and Rates of Surgical Site Infections for General Surgical, Neurological, and Orthopedic Procedures

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00562-11 ◽

2011 ◽

Vol 55 (10) ◽

pp. 4659-4663 ◽

Cited By ~ 36

Author(s):

Barnaby Young ◽

Tat Ming Ng ◽

Christine Teng ◽

Brenda Ang ◽

Hwei Yee Tai ◽

...

Keyword(s):

Surgical Site Infection ◽

Antibiotic Prophylaxis ◽

Univariate Analysis ◽

Surgical Site Infections ◽

Orthopedic Procedures ◽

Site Infection ◽

Chi Square ◽

Chi Square Test ◽

Prevention Guidelines ◽

Complication Of Surgery

ABSTRACTSurgical site infection (SSI) is a common and preventable complication of surgery, but the relative importance of individual measures recommended by guidelines has not been determined. Elective general surgical, neurological, and orthopedic procedures requiring antibiotic prophylaxis from a 3-month period were retrospectively studied to determine concordance with SSI prevention guidelines and to identify factors which predicted the development of SSIs. A total of 216 surgeries were reviewed, with 18 SSIs (8.3%). A mean of 1.4 antibiotic prophylaxis errors per surgery were identified, with correct antibiotic type identified for 64%, antibiotic timing for 83%, supplemental antibiotic dosing for 34%, and antibiotic duration of less than 24 h for 44%. Normothermia was present in 79% of surgeries, and normoglycemia was present in 17%. Univariate analysis of the SSI rate identified four significant factors. Antibiotic prophylaxis for less than 24 h postoperatively (odds ratio [OR], 0.213; 95% confidence interval [95% CI]0.060 to 0.757) and neurosurgery (OR, 0.118; 95% CI, 0.15 to 0.903) correlated with a reduced risk of SSI. The mean number of prophylaxis errors (OR, 1.6; 95% CI, 1.02 to 2.4) and a duration of surgical drainage for more than 3 days (OR, 2.679; 95% CI, 1.009 to 7.113) predicted SSI. By multivariate analysis, errors in individual antibiotic prophylaxis measures were not significantly associated with SSI; however, the presence of more than two errors was significant (OR, 4.030; 95% CI, 1.018 to 15.96). A strong correlation was identified between the degree of concordance to SSI prevention guidelines and the SSI rate (P= 0.001, Mantel-Haenszel linear-by-linear association chi-square test).

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Surgical-Site Infection After Cardiac Surgery: Incidence, Microbiology, and risk Factors

Infection Control and Hospital Epidemiology ◽

10.1086/502569 ◽

2005 ◽

Vol 26 (5) ◽

pp. 466-472 ◽

Cited By ~ 71

Author(s):

Didier Lepelletier ◽

Stéphanie Perron ◽

Philippe Bizouarn ◽

Jocelyne Caillon ◽

Henri Drugeon ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Artery Bypass ◽

Risk Index ◽

Bypass Graft ◽

Surgical Site Infections ◽

Incidence Rates ◽

Site Infection ◽

Internal Mammary ◽

System Risk

AbstractObjective:To identify risk factors associated with surgical-site infection according to the depth of infection, the cardiac procedure, and the National Nosocomial Infections Surveillance System risk index.Design:Prospective survey conducted during a 12-month period.Setting:A 48-bed cardiac surgical department in a teaching hospital.Patients:Patients admitted for cardiac surgery between February 2002 and January 2003.Results:Surgical-site infections were diagnosed in 3% of the patients (38 of 1,268). Of the 38 surgical-site infections, 20 were superficial incisional infections and 18 were mediastinitis for incidence rates of 1.6% and 1.4%, respectively. Cultures were positive in 28 cases and the most commonly isolated pathogen wasStaphylococcus. A National Nosocomial Infections Surveillance System risk index score of 2 or greater was associated with a risk of surgical-site infection (relative risk, 2.4;P< .004). Heart transplantation, mechanical circulatory assistance, coronary artery bypass graft with the use of internal mammary artery, and reoperation for cardiac tamponade or pericard effusion were independent risk factors associated with surgical-site infection.Conclusions:Data surveillance using incidence rates stratified by cardiac procedure and type of infection is relevant to improving infection control efforts. Risk factors in patients who developed superficial infection were different from those in patients who developed mediastinitis. Coronary artery bypass graft using internal mammary artery was associated with a high risk of surgical-site infection, and independent factors such as reoperation for cardiac tamponade or pericard effusion increased the risk of infection.

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Efficacy of Non-Beta-lactam Antibiotics for Prevention of Cesarean Delivery Surgical Site Infections

American Journal of Perinatology Reports ◽

10.1055/s-0039-1685503 ◽

2019 ◽

Vol 09 (02) ◽

pp. e167-e171 ◽

Cited By ~ 3

Author(s):

Benjamin Harris ◽

Maeve Hopkins ◽

Margaret Villers ◽

Jeremy Weber ◽

Carl Pieper ◽

...

Keyword(s):

Surgical Site Infection ◽

Cesarean Delivery ◽

Surgical Site Infections ◽

Type I ◽

Site Infection ◽

Beta Lactam ◽

Postpartum Visit ◽

Chi Square ◽

Lower Odds ◽

Logistic Regression Models

Objective To examine the association between perioperative Beta (β))-lactam versus non-β-lactam antibiotics and cesarean delivery surgical site infection (SSI). Study Design Retrospective cohort of women undergoing cesarean delivery from January 1 to December 31, 2014. All women undergoing cesarean after 34 weeks with a postpartum visit were included. Prevalence of SSI was compared between women receiving β-lactam versus non-β-lactam antibiotics. Bivariate analyses were performed using Pearson's Chi-square, Fisher's exact, or Wilcoxon's rank-sum tests. Logistic regression models were fit controlling for possible confounders. Results Of the 929 women included, 826 (89%) received β-lactam prophylaxis and 103 (11%) received a non-β-lactam. Among the 893 women who reported a non-type I (low risk) allergy, 819 (92%) received β-lactam prophylaxis. SSI occurred in 7% of women who received β-lactam antibiotics versus 15% of women who received a non-β-lactam (p = 0.004). β-Lactam prophylaxis was associated with lower odds of SSI compared with non-β-lactam antibiotics (odds ratio [OR] = 0.43; 95% confidence interval [CI] = 0.22–0.83; p = 0.01) after controlling for chorioamnionitis in labor, postlabor cesarean, endometritis, tobacco use, and body mass index (BMI). Conclusion β-Lactam perioperative prophylaxis is associated with lower odds of a cesarean delivery surgical site infection compared with non-β-lactam antibiotics.

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Surgical Site Infections (SSI) and factors associated in a private tertiary care teaching hospital in Raichur, Karnataka, India

International Surgery Journal ◽

10.18203/2349-2902.isj20183211 ◽

2018 ◽

Vol 5 (8) ◽

pp. 2899

Author(s):

Prashanta Swami Pujar ◽

K. B. Phuleker ◽

Nagaraj Bhalki

Keyword(s):

Risk Factors ◽

Tertiary Care ◽

Surgical Site Infections ◽

Research Centre ◽

Chi Square ◽

College Hospital ◽

Factors Associated ◽

Duration Of Surgery ◽

Chi Square Test ◽

A Prospective Study

Background: Prevention of Surgical site infection (SSI) remains a focus of attention because wound infections continue to be a major source of expense, morbidity, and even mortality. Three quarters of deaths of surgical patients with SSIs are attributed to nosocomial infections, nearly all of which are organ/space infections. The objective of the present study was to estimate the incidence of SSI and to study the various risk factors associated with SSI.Methods: This is a prospective study of 180 eligible cases eligible subjects, who underwent various surgeries in the department of General Surgery after applying inclusion and exclusion criteria. The study conducted at the Navodaya Medical College Hospital and Research Centre, Raichur. The tenure for the study was April 2017 to June 2017. Data was collected using pretested proforma. Data was analysed using SPSS version 16. Chi -square test and multiple logistic regression was applied to know the association between various risk factors and occurrence of SSI.Results: Among 180 patients 33 (18.33%) developed surgical site infections (SSI). Among 33 SSIs 25 (75.76%) were grade 3 and 8 (24.24%) were grade 4 infections. SSIs were found more commonly among patients over 50 years, diabetics, HIV infected patients, patients with longer duration of surgery and associations with these factors were found statistically significant.Conclusions: The incidence rate of SSI was quite high, and its end results will have a greater impact on patients as well as on healthcare systems. Prevention of SSI requires multipronged approach targeting both patient related and procedure related risk factors in pre- operative, intra-operative, and post-operative period.

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An observational study of incidence of surgical site infections in gastrointestinal surgeries

International Surgery Journal ◽

10.18203/2349-2902.isj20214751 ◽

2021 ◽

Vol 8 (12) ◽

pp. 3595

Author(s):

Jenishkumar Vijaykumar Modi ◽

Darshit Kalaria

Keyword(s):

Risk Factors ◽

Observational Study ◽

Surgical Site Infection ◽

Infection Rate ◽

Surgical Site Infections ◽

Site Infection ◽

Infection Rates ◽

Surgical Site Infection Rate ◽

Long Time ◽

Surgery Department

Background: This study analysed the incidence of surgical site infections in gastrointestinal surgeries and its risk factors. so this study helped us in reducing surgical site infection by avoiding or minimizing that risk factors.Methods: The present study was conducted at general surgery department, SMIMER, Surat. An observational study of 400 cases that have undergone abdominal surgery in SMIMER hospital and were followed up from the day of operation to 30 days after discharge was done.Results: The overall infection rate for a total of the 400 cases was 17.25%. The incidence rate in this study was well within the infection rates of 2.8% to 17% seen in other studies. Different studies from India at different places have shown the SSI (surgical site infection) rate to vary from 6.09% to 38.7%.Conclusions: Our study reveals that though SSIs have been widely studied since a long time, they still remain as one of the most important causes of morbidity and mortality in surgically treated patients.

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Abdominal Surgical Site Infection Incidence and Risk Factors in a Mexican Population

Advances in Skin & Wound Care ◽

10.1097/01.asw.0000557833.80431.00 ◽

2019 ◽

Vol 32 (6) ◽

pp. 1-6

Author(s):

Crystell Guzmán-García ◽

Oscar I. Flores-Barrientos ◽

Isela E. Juárez-Rojop ◽

Julio C. Robledo-Pascual ◽

Manuel A. Baños-González ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Mexican Population ◽

Site Infection ◽

Infection Incidence ◽

Surgical Site Infection Incidence

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Risk Factors for Cesarean Section Surgical Site Infections: A Systematic Review

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1009 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s377-s377

Author(s):

Feah Visan ◽

Jenalyn Castro ◽

Yousra Siam Shahada ◽

Naser Al Ansari ◽

Almunzer Zakaria

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Body Mass Index ◽

Risk Factor ◽

Cesarean Section ◽

Surgical Site Infection ◽

Body Mass ◽

Surgical Site Infections ◽

Site Infection ◽

Inclusion Criteria

Background: According to the CDC NHSN, surgical site infections (SSI) are wound infections that develop within 30 days postoperatively for nonimplanted surgeries such as cesarean sections. SSIs is shown to manifest in a continuum of a purulent discharge from surgical site to severe sepsis. It contributes to rising morbidity, mortality and prolonged length of stay. Objective: To describe risk factors to the development of SSI in cesarean section in descriptive studies. Methods: The Preferred Reporting Items for Systematic Reviews (PRISMA) reporting guidelines is used as method for this systematic review. A PubMed literature search was conducted, limited to published articles in English from 1998 to 2016 using the broad key terms “cesarean section,” “surgical site infection,” and “risk factor.” The following inclusion criteria were applied to all reviews: (1) peer-reviewed journal, (2) computed risk factor for SSI development, and (3) calculated SSI rate. Reviews of references of the include studies were conducted, and 7 studies were appraised, with only 1 accepted. Results: After extracting data from 52 article reviews, 23 were finally accepted based on the inclusion criteria. Most studies were multivariate studies (n = 8) followed by cohort studies (n = 6). Unique numerators and denominators for SSI reviews were mentioned in all 23 studies, of which 22 studies followed the CDC NHSN definitions for SSI. Within the 23 studies, most studies showed that obesity (11.46%) is a common maternal risk factor for the development of postoperative cesarean section SSI. Conclusions: Identifying that obesity is a major contributor of surgical site infection in postoperative cesarean section women is a topic that warrants exploration. The relationship of cesarean section SSI to obesity should be investigated, specifically highlighting the level of obesity based on the WHO international body mass index (BMI) classification and the development of SSI. A correlation between increasing wound infection rates and increasing body mass index should be studied further. Published recommendations for preventing SSIs in this population should be reviewed.Funding: NoneDisclosures: None

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Prevalence of surgical site infections and their sensitivity patterns in elective abdominal surgeries in King George Hospital, Visakhapatnam

International Surgery Journal ◽

10.18203/2349-2902.isj20202830 ◽

2020 ◽

Vol 7 (7) ◽

pp. 2247

Author(s):

Pratha Anantha Ramani ◽

Simhadri Uday Kiran ◽

Murali Manohar Deevi ◽

Ginni Vijay Sainath Reddy ◽

Ginjupalli Saichand ◽

...

Keyword(s):

Risk Factors ◽

Surgical Site Infection ◽

Surgical Site Infections ◽

Wound Dressings ◽

Site Infection ◽

Antibiotic Resistant ◽

Clean Contaminated ◽

King George Hospital ◽

A Prospective Study ◽

Prolonged Hospital

Background: Surgical site infections are one of the most common complications in the postoperative period leading to increased morbidity, prolonged hospital stay and reduced quality of life. The present study aims to identify the incidence of surgical site infection (SSI), risk factors, causative organisms, and their sensitivity patterns in patients who have undergone elective abdominal surgeries.Methods: A prospective study containing 200 patients who have undergone elective abdominal surgeries from May 2018 to January 2020 were evaluated. A thorough history was taken in all the patients. A detailed clinical examination and routine investigations were done. Parameters such as body mass index (BMI), diabetic status, type of surgery, wound grading, culture, and sensitivity patterns were considered. The patients underwent treatment based on their investigatory reports.Results: In the present study, 54 patients developed surgical site infection, and among them, 22 are diabetics. Only ten patients with normal BMI developed SSI, whereas the other 44 patients who developed SSI had abnormal BMI. The incidence of SSI was higher in clean-contaminated surgeries comprising up to 89% of cases. Staphylococcus aureus was the most commonly isolated organism, and cefoperazone plus sulbactam was the most sensitive on antibiogram.Conclusions: The surgical site infections are on rising trend due to the emergence of antibiotic-resistant microorganisms. Treatment of the underlying risk factors, regular wound dressings, and antibiotics, according to sensitivity patterns, are the mainstay.

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Incidence, risk factors and Microorganisms for post caesarean Surgical Site Infection In A Tertiary Care Centre in Bangladesh

Journal of Dhaka Medical College ◽

10.3329/jdmc.v28i2.51148 ◽

2021 ◽

Vol 28 (2) ◽

pp. 136-141

Author(s):

Shahfinaz Mehzabin ◽

Mohmmad Mahbub Elahi ◽

Debashish Bar ◽

Banalata Sinha ◽

Tahmina Akter ◽

...

Keyword(s):

Risk Factors ◽

Caesarean Section ◽

Surgical Site Infection ◽

Surgical Site Infections ◽

Site Infection ◽

Medical College ◽

Related Risk ◽

Microbiological Methods ◽

Duration Of Surgery ◽

History Of

Background: Surgical site infection (SSI) is a common complication following caesarean section (C-section) and mainly responsible for increased maternal morbidity and higher treatment costs. This study will determine the incidence and risk factors of surgical site infections following caesarean section in Dhaka Medical College Hospital (DMCH). Materials and Methods: This is a retrospective observational study which was conducted among patients having post caesarean surgical site infections attending post-natal outdoor clinic of DMCH from January, 2019 to December, 2019. Data were collected in structured questionnaire. Culturebased microbiological methods were used to identify causal agents in postoperative wounds. Results: Overall SSI rate following caesarian section was 4.44%.Patient related risk factors were inadequate antenatal check-up, emergency procedures, malnutrition (22.44%), anaemia (21.46%) associated comorbidity (59.46%), history of rupture membrane >12 hours (40.98%) and had history of prolonged labour pain >12 hours (16.10%).Surgery related risk factors were repeated per vaginal examinations by untrained birth attendant (21.95%) & duration of surgery>1 hour (62.93%). The most common organisms responsible for SSI were Staphylococcus aureus 44(21.46%) and Escherichia coli 31(15.12%). The most sensitive antibiotics were aminoglycosides, cephalosporin & cloxacillin. Conclusion: Most of the risk factors for surgical site infection following caesarean section identified in this study can be modified through intervention. However the microorganisms detected from our patient showed a high degree of resistance for commonly prescribed antimicrobials in our set-up. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 136-141

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