Surgical Site Infection After Breast Surgery-A Bicentric Retrospective Case-Control Study in Saudi Arabia

Area of Science:

• Infectious Diseases
• Surgical Outcomes
• Public Health Surveillance

Background:

• Surgical site infections (SSIs) are frequent postoperative complications, yet data on breast surgery SSIs in Saudi Arabia are scarce.
• Breast surgeries are not currently part of the national SSI surveillance system in Saudi Arabia.
• This study addresses the gap by investigating SSI incidence, risk factors, and microbial profiles in Saudi Arabian breast surgery patients.

Purpose of the Study:

• To determine the incidence rate of surgical site infections (SSIs) following breast surgery in Saudi Arabia.
• To identify risk factors associated with the development of SSIs in this patient population.
• To characterize the microbiological profile of SSIs occurring after breast surgery.

Main Methods:

• A bicentric retrospective case-control study analyzing 1841 breast surgeries from July 2021 to July 2024.
• Data extraction from electronic medical records, including demographic, surgical, and microbiological information.
• Matched case-control analysis (1:4 ratio) of 172 patients and multivariable logistic regression to identify SSI predictors.

Main Results:

• The overall cumulative SSI incidence was 2.4%, with 69% of infections occurring within 30 days post-surgery.
• Gram-negative organisms (53.6%), primarily *Klebsiella pneumoniae* and *Pseudomonas aeruginosa*, predominated. *Staphylococcus aureus* (including MRSA) accounted for 25%.
• Immunocompromised status (OR 3.32) and surgical drain use (OR 4.07) were independently linked to increased SSI risk.

Conclusions:

• The incidence of SSIs following breast surgery in Saudi Arabia is relatively low.
• The prevalence of Gram-negative pathogens and identified risk factors (immunocompromised status, drain use) suggest areas for focused infection control.
• Further research with larger, diverse populations is recommended to validate these findings and refine prevention strategies.