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 .
Incidence and predictors of infection in patients undergoing primary isolated coronary artery bypass grafting: a report from a tertiary care hospital in a developing country.
AIM Infection following coronary artery bypass grafting ( CABG )  is a leading cause of morbidity , mortality , and increased length of hospital stay . Many studies have investigated the predictive value of known risk factors for infection in patients following CABG and conclusions have been variable and may reveal regional or institution-specific influence . The purpose of this prospect i ve study was to determine the pre- and peri-operative risk factors for infection in patients undergoing coronary artery bypass surgery in a developing country . METHODS A prospect i ve study was undertaken to collect data on 12 reported risk factors for all patients undergoing CABG during a five-year period at The Aga Khan University Hospital , Pakistan . The relationship of these risk factors to infection following CABG was evaluated . RESULTS Out of 767 consecutive patients admitted for CABG , a total of 73 ( 9.51 % ) developed 92 infections following surgery . Sternal Surgical Site Infection ( SSI ) developed in 30 patients ( 3.91 % ) , of which 29 ( 96.7 % ) were superficial and 1 ( 3.33 % ) was deep . There were 37 leg wound infections at the site of conduit harvest , and 2 cases of infection at the intra-aortic balloon pump . There were 12 cases of sepsis and 11 urinary tract infections . There were 26 cases ( 35.6 % ) of leukocytosis and 17 patients ( 23.3 % ) showed elevated erythrocyte sedimentation rate ( ESR ) . Staphylococcus aureus was the most frequently isolated pathogen ( 39.7 % ) . Bacteremia data was not collected . Of the total cases of infection following CABG , 59 required prolonged hospitalization or readmission . Univariate analysis was performed using a p-value of < 0.2 as the inclusion criteria for further analysis using logistic regression . Multivariate analysis with adjusted Relative Risk ( RR ) showed that diabetes ( P=0.002 , RR=2.3 , 95 % CI=1.4 - 4.0 ) , obesity ( P=0.036 , RR=2.2 , 95 % CI=1.0 - 4.4 ) , use of an intra-aortic balloon pump ( P=0.001 , RR=3.6 , 95 % CI=1.7 - 7.7 ) , female gender ( P=0.004 , RR=2.5 , 95 % CI=0.2 - 0.8 ) and prolonged mechanical ventilation ( P=<0.0001 , RR=6.7 , 95 % CI=2.8 - 15.5 ) were independent predictors of infection in the study population . CONCLUSION This study suggests that diabetes , obesity , use of an intra-aortic balloon pump and female gender are independent predictors of infection in patients undergoing CABG . Early and strict diabetic control and pre-operative weight reduction may reduce the incidence of infection following CABG . Contamination of these patients may occur before , during and after the operation and efforts to curb such contamination must be intensive . Further prospect i ve studies need to be undertaken to identify and establish these and other risk factors for infection in the region and elsewhere
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 .