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 .
Predictors of surgical site infections among patients undergoing major surgery at Bugando Medical Centre in Northwestern Tanzania
Background Surgical site infection ( SSI ) continues to be a major source of morbidity and mortality in developing countries despite recent advances in aseptic techniques . There is no baseline information regarding SSI in our setting therefore it was necessary to conduct this study to establish the prevalence , pattern and predictors of surgical site infection at Bug and o Medical Centre Mwanza ( BMC ) , Tanzania . Methods This was a cross-sectional prospect i ve study involving all patients who underwent major surgery in surgical wards between July 2009 and March 2010 . After informed written consent for the study and HIV testing , all patients who met inclusion criteria were consecutively enrolled into the study . Pre-operative , intra-operative and post operative data were collected using st and ardized data collection form . Wound specimens were collected and processed as per st and ard operative procedures ; and susceptibility testing was done using disc diffusion technique . Data were analyzed using SPSS software version 15 and STATA . Results Surgical site infection ( SSI ) was detected in 65 ( 26.0 % ) patients , of whom 56 ( 86.2 % ) and 9 ( 13.8 % ) had superficial and deep SSI respectively . Among 65 patients with clinical SSI  , 56(86.2 % ) had positive aerobic culture . Staphylococcus aureus was the predominant organism 16/56 ( 28.6 % ) ; of which 3/16 ( 18.8 % ) were MRSA . This was followed by Escherichia coli 14/56 ( 25 % ) and Klebsiella pneumoniae 10/56 ( 17.9 % ) . Among the Escherichia coli and Klebsiella pneumoniae isolates 9(64.3 % ) and 8(80 % ) were ESBL producers respectively . A total of 37/250 ( 14.8 % ) patients were HIV positive with a mean CD4 count of 296 cells/ml . Using multivariate logistic regression analysis , presence of pre-morbid illness ( OR = 6.1 ) , use of drain ( OR = 15.3 ) , use of iodine alone in skin preparation ( OR = 17.6 ) , duration of operation ≥ 3 hours ( OR = 3.2 ) and cigarette smoking ( OR = 9.6 ) significantly predicted surgical site infection ( SSI ) ConclusionS SI is common among patients admitted in surgical wards at BMC and pre-morbid illness , use of drain , iodine alone in skin preparation , prolonged duration of the operation and cigarette smoking were found to predict SSI . Prevention strategies focusing on factors associated with SSI is necessary in order to reduce the rate of SSI in our setting
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 .