AND RELEVANCE In a broad review of published literature , risk factors for SSI were characterized as describing reduced fitness , patient frailty , surgery duration , and complexity .
IMPORTANCE Surgical site infection ( SSI ) complicates 2 - 5 % of surgeries in the United States .
Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis , and SSIs are responsible for increased morbidity , mortality , and economic burden associated with surgery .
Staphylococcus aureus ( S. aureus ) is a commonly-isolated organism for SSI , and methicillin-resistant S. aureus SSI incidence is increasing globally .
OBJECTIVE The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting .
The deadly toll of invasive methicillin-resistant Staphylococcus aureus infection in community hospitals.
INTRODUCTION Data regarding the epidemiology , treatment , and outcomes of methicillin-resistant Staphylococcus aureus ( MRSA ) infections in rural and community hospitals are limited . METHODS This cohort study was conducted at 1 tertiary care hospital and 8 community hospitals in the southeastern United States . Patients with a surgical site infection ( SSI ) and /or bacteremia due to MRSA were prospect ively identified at each study hospital during the period 1994 - 2003 . RESULTS A total of 129 patients with SSI and 564 patients with bacteremia due to MRSA were identified . Only 57 patients with SSI ( 44.2 % ) received antibiotics active against MRSA on the initial date of diagnosis ; only 95 ( 73.6 % ) received an agent active against MRSA by day 7 after diagnosis of SSI due to MRSA . Ninety-five patients with SSI due to MRSA ( 73.6 % ) were readmitted to the hospital within 90 days after their original surgery . The 1-year mortality rate among patients with SSI due to MRSA was 22 % . Inadequate therapy was also commonly given to patients with bacteremia : only 216 ( 38.3 % ) received antibiotics active against MRSA on the initial day of infection , and only 383 ( 67.9 % ) received an agent active against MRSA by day 7 after diagnosis . Approximately one-third of patients with bloodstream infection died during their initial hospitalization . Patients hospitalized in community hospitals were less likely to receive effective antimicrobial therapy  on both the day of infection and within 7 days after infection , compared with patients in the tertiary care hospital . CONCLUSION Inadequate therapy is commonly administered after diagnosis of SSI and bacteremia due to MRSA in patients in community hospitals
AND RELEVANCE In a broad review of published literature , risk factors for SSI were characterized as describing reduced fitness , patient frailty , surgery duration , and complexity .
IMPORTANCE Surgical site infection ( SSI ) complicates 2 - 5 % of surgeries in the United States .
Severity of SSI ranges from superficial skin infection to life-threatening conditions such as severe sepsis , and SSIs are responsible for increased morbidity , mortality , and economic burden associated with surgery .
Staphylococcus aureus ( S. aureus ) is a commonly-isolated organism for SSI , and methicillin-resistant S. aureus SSI incidence is increasing globally .
OBJECTIVE The objective of this systematic review was to characterize risk factors for SSI within observational studies describing incidence of SSI in a real-world setting .