Objectives: To quantify the surgical infection rate and to identify risk fa
ctors 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 infecti
on per 100 surgeries was calculated. The odds ratio (OR) was estimated by u
sing 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 fac
tors 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 greater than or equal
to 16 days (OR = 2.14, 95% CI = 1.0-4.6). The bacteria most frequently iso
lated 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 in
fections was greater among the casts (OR = 1.8, 95% CI = 1.1-3.1) than in t
he control group.
Conclusions: The surgical site infection rate in our hospital is slightly h
igher than the rates reported for general hospitals. The risk factors assoc
iated with surgical site infection are similar to those previously reported
. Diabetes mellitus, obesity, and prolonged presence of a surgical drain in
creased the risk of infection.