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Surgical site infections at the National Cancer Institute in Mexico: a case-control study
D Vilar-Compte1, A Mohar, S Sandoval
1Department of Infectious Diseases and the Clinical Research Investigation Division, Instituto Nacional de Cancerología, Mexico, D.F 14000, Mexico.
Objectives:
To quantify the surgical infection rate and to identify risk factors associated with surgical site infection.
Methods:
We conducted a case-control study of all surgical patients between January 1, 1993, and June 30, 1994. The frequency of surgical site infection per 100 surgeries was calculated. The odds ratio (OR) was estimated by using logistic regression analysis.
Setting:
A 130-bed tertiary-care teaching hospital for adult patients with cancer.
Results:
The study followed 3372 surgeries. Three hundred thirteen patients had a surgical site infection (rate per 100 surgeries: 9. 30). The risk factors associated with surgical site infection were diabetes mellitus (OR = 2.5, 95% confidence interval [CI] = 1.27-4. 91), obesity (OR = 1.76, 95% CI = 1.14-2.7), presence of surgical drains for >5 and <16 days (OR = 1.84, 95% CI = 1.02-3.31), and presence of surgical drains for >/=16 days (OR = 2.14, 95% CI = 1. 0-4.6). The bacteria most frequently isolated were Escherichia coli 38 (21.8% of the total of microorganisms found), Pseudomonas sp 22 (12.6%), Staphylococcus aureus 16 (9.2%), and coagulase-negative Staphylococcus 25 (13.6%). The coexistence of other nosocomial infections was greater among the cases (OR = 1.8, 95% CI = 1.1-3.1) than in the control group.
Conclusions:
The surgical site infection rate in our hospital is slightly higher than the rates reported for general hospitals. The risk factors associated with surgical site infection are similar to those previously reported. Diabetes mellitus, obesity, and prolonged presence of a surgical drain increased the risk of infection.
Insights
This study found a surgical site infection rate of 9.3% in cancer patients, with diabetes, obesity, and prolonged drain use increasing infection risk. These findings highlight key factors for preventing surgical site infections in high-risk populations.
Area of Science:
- Infectious Disease Epidemiology
- Surgical Outcomes Research
- Oncology Patient Care
Background:
- Surgical site infections (SSIs) are a significant concern in healthcare settings, impacting patient recovery and increasing healthcare costs.
- Identifying specific risk factors is crucial for developing targeted prevention strategies.
Purpose of the Study:
- To determine the incidence of surgical site infections (SSIs) in adult cancer patients.
- To identify and quantify risk factors associated with the development of SSIs.
Main Methods:
- A case-control study was conducted involving adult cancer patients undergoing surgery between January 1993 and June 1994.
- Surgical infection rates were calculated per 100 surgeries, and logistic regression analysis was used to estimate odds ratios (OR) for risk factors.
Main Results:
- The study included 3372 surgeries, with a 9.3% surgical site infection rate.
- Identified risk factors for SSIs included diabetes mellitus (OR=2.5), obesity (OR=1.76), and the presence of surgical drains for extended periods (OR=1.84 to 2.14).
- Escherichia coli, Pseudomonas sp., Staphylococcus aureus, and coagulase-negative Staphylococcus were the most common pathogens. Co-occurrence of other nosocomial infections was higher in cases (OR=1.8).
Conclusions:
- The SSI rate in this tertiary-care cancer hospital was slightly elevated compared to general hospitals.
- Diabetes mellitus, obesity, and prolonged use of surgical drains are significant risk factors for SSIs.
- Findings underscore the importance of managing comorbidities and optimizing drain management to reduce infection risk in surgical oncology patients.