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Epidemiological patterns, risk factors, and prevention gaps of surgical site infections in operating rooms: a
Hong Cheng1,2, Fan Wu3,4, Huixin Zhu1,2
1Department of Surgical Nursing Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Background:
Surgical site infections (SSIs) remain a major cause of postoperative morbidity, prolonged hospitalization, and increased healthcare costs.
Objective:
To evaluate the incidence, risk factors, microbiological profile, preventive measures, and outcomes of SSIs to inform targeted perioperative strategies.
Methods:
A hospital-based surveillance cohort study included 4,632 patients undergoing 4,860 surgical procedures between January 2022 and December 2024. Multivariate logistic regression identified independent predictors.
Results:
A total of 382 patients developed SSIs (8.25%), corresponding to an incidence density of 12.4 per 1,000 patient-days. Independent predictors included hypoalbuminemia (OR 2.91), contaminated wounds (OR 2.83), emergency surgery (OR 2.66), operative duration >120 min (OR 2.41), and >20 operating room door openings (OR 1.77). Additional risk was associated with diabetes, anemia, ASA ≥ III status, and perioperative transfusion. Adherence to timely antibiotic prophylaxis and chlorhexidine skin preparation significantly reduced the risk of SSI (OR 0.39-0.51). Staphylococcus aureus accounted for 31.4% of cases, while Gram-negative bacilli exhibited high multidrug resistance. SSIs prolonged hospital stay by 8.9 days, tripled ICU admissions, increased 30-day mortality fourfold, and added approximately USD 2,450 in direct costs. The predictive model demonstrated strong discrimination (AUC 0.84) and good calibration.
Conclusion:
SSIs impose substantial clinical and economic burdens. Optimized perioperative care, strict adherence to prophylactic protocols, and improved environmental control measures are critical to reducing infection rates and improving surgical outcomes.
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