Surgical site infections occurrence and associated risk factors: a matched case-control study

TL;DR

This study identifies risk factors for surgical site infections, including age and hypoalbuminemia, and finds that antibiotic redosing may reduce infection risk.

Contribution

The study provides new insights into SSI risk factors and the protective effect of antibiotic redosing during surgery.

Findings

Hypoalbuminemia and age ≥65 years are significantly associated with surgical site infections.

Antibiotic redosing during surgery is linked to lower odds of SSIs.

Gastrointestinal surgeries had the highest SSI rates despite appropriate antibiotic protocols.

Abstract

Surgical site infections (SSIs) pose a significant healthcare challenge, raising patient morbidity, mortality, and costs. Various intrinsic, patient-specific, and perioperative factors contribute to SSIs. This study aims to identify SSI-associated risk factors, microorganism types, and antibiotic susceptibility patterns in surgical patients.

This is a matched-case control study.

The Lebanese American University Medical Center – Rizk Hospital, Beirut Lebanon.

The study included surgical patients.

This retrospective case-control study analyzed data from surgical patients over a five-year period, matching 113 SSI cases with controls in a 1:3 ratio by gender and surgery type.

Among 324 patients (81 cases vs 243 controls), hypoalbuminemia (<3.5 g/dL) and age ≥65 years were significantly associated with SSIs (P = .025 and P = .039), respectively. Antibiotic redosing was associated with lower odds of SSIs (OR = 0.19, P = .042), indicating a potential protective effect.

Our findings were consistent with similar studies. Elderly patients and those with hypoalbuminemia were found to be at significantly higher risk of SSIs. Also, antibiotic redosing during prolonged surgeries was associated with reduced SSI risk. In terms of SSI rates, gastrointestinal surgeries (GIs) were the highest with 42.3% of GI cases followed appropriate antibiotic protocols. Like other studies, predominant microorganisms at wound site included E. coli and coagulase-negative staphylococci.

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