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 .
Standardized incidence rates of surgical site infection: a multicenter study in Thailand.
BACKGROUND No previous multicenter data regarding the incidence of  surgical site infection ( SSI ) are available in Thail and . The magnitude of the problem result ing from SSI at the national level could not be assessed . The purpose of this study was to estimate the incidence of SSI in 9 hospitals , together with patterns of surgical antibiotic prophylaxis , risk factors for SSI , and common causative pathogens . METHODS A prospect i ve data collection among patients undergoing surgery in 9 hospitals in Thail and was conducted . The National Nosocomial Infection Surveillance ( NNIS ) system criteria and method were used for identifying and diagnosing SSI . The SSI rates were benchmarked with the NNIS report by means of indirect st and ardization and reported in terms of st and ardized infection ratio ( SIR ) . Antibiotic prophylaxis was categorized into preoperative , intraoperative , and postoperative . Risk factors for SSI were evaluated using multiple logistic regression models . RESULTS From July 1 , 2003 , to February 29 , 2004 , the study included 8764 patients with 8854 major operations and identified 127 SSIs , yielding an SSI rate of 1.4 infections/100 operations and a corresponding SIR of 0.6 ( 95 % CI : 0.5 - 0.8 ) . Of these , 35 SSIs ( 27.6 % ) were detected postdischarge . The 3 most common operative procedures were cesarean section , appendectomy , and hysterectomy . The 3 most common pathogens isolated were Escherichia coli , Staphylococcus aureus , and Pseudomonas aeruginosa , which accounted for 15.3 % , 8.5 % , and 6.8 % of infections , respectively . The 3 most common antibiotics used for prophylaxis were ampicillin/amoxicillin , cefazolin , and gentamicin . The proportion of types of antibiotic prophylaxis administered were 51.6 % preoperative , 24.3 % intraoperative , and 24.1 % postoperative . Factors significantly associated with SSI were high degree of wound contamination , prolonged preoperative hospital stay , emergency operation , and prolonged duration of operation . CONCLUSION Overall SSI rates were less than the average NNIS rates . The causative pathogens of SSI were different from those of other reports . There was a crucial proportion of operations that did not comply with the antibiotic guidelines . The risk factors for SSI identified in this study were consistent with most other reports
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 .