A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center
Abstract Objective: To investigate a cluster of surgical site infections (SSIs) in patients who underwent coronary artery bypass graft (CABG) procedures, identify risk factors for infection, and implement measures to prevent new cases. Design: The investigation comprised a retrospective case–con...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2025-01-01
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| Series: | Antimicrobial Stewardship & Healthcare Epidemiology |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2732494X25001640/type/journal_article |
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| author | Alaina S. Ritter Vidya Kollu Amanda Aspilcueta Jennifer D. Connolly Eddie Manning Lennox Archibald |
| author_facet | Alaina S. Ritter Vidya Kollu Amanda Aspilcueta Jennifer D. Connolly Eddie Manning Lennox Archibald |
| author_sort | Alaina S. Ritter |
| collection | DOAJ |
| description |
Abstract
Objective:
To investigate a cluster of surgical site infections (SSIs) in patients who underwent coronary artery bypass graft (CABG) procedures, identify risk factors for infection, and implement measures to prevent new cases.
Design:
The investigation comprised a retrospective case–control study and an observational review of infection control practices between the fall of 2018 and 2019 (study period).
Setting:
Tertiary care medical center in Florida, USA.
Patients:
Patients who acquired an SSI following CABG during the study period were defined as case-patients. Control-patients were randomly selected patients who did not acquire a post-CABG SSI.
Methods:
We recorded clinical and epidemiologic details on a standardized form and analyzed data with SAS statistical software. Odds ratios and 95% confidence intervals were calculated.
Results:
Seven patients met the case definition and 21 control-patients were identified. While multiple variables were significant on univariate analysis, after controlling for confounding using multivariate analysis/logistic regression, only lower age (P < 0.0001) and meeting the requirements for appropriate perioperative temperature management (SCIP measure 10) (P = 0.01) were identified as independent risk factors for SSI. Per observational review, measures to reduce operating room traffic and limit door opening/closing were implemented and wound vacuum-assisted closure (VAC) use was phased out. Our institutional SSI rate returned to baseline and no additional clusters were seen in the following three years.
Conclusions:
Multiple potential risk factors exist for SSI after coronary artery bypass grafting. At our institution, minimizing operating room traffic and reducing wound VAC use may have successfully addressed these healthcare-associated infections.
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| format | Article |
| id | doaj-art-da711b5bd9884138a87012e644a3eae5 |
| institution | OA Journals |
| issn | 2732-494X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | Antimicrobial Stewardship & Healthcare Epidemiology |
| spelling | doaj-art-da711b5bd9884138a87012e644a3eae52025-08-20T02:09:12ZengCambridge University PressAntimicrobial Stewardship & Healthcare Epidemiology2732-494X2025-01-01510.1017/ash.2025.164A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical centerAlaina S. Ritter0https://orcid.org/0000-0002-8216-3588Vidya Kollu1https://orcid.org/0000-0002-3833-0916Amanda Aspilcueta2https://orcid.org/0009-0002-4849-417XJennifer D. Connolly3Eddie Manning4Lennox Archibald5Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, USA Division of Infectious Diseases, North Florida South Georgia VA Medical Center, Gainesville, FL, USAInfectious Disease, HCA North Florida Hospital, Gainesville, FL, USAInfection Control Division, Malcom Randall Veterans Affairs Medical Center, Gainesville, USA (Retired)College of Nursing, North Florida South Georgia VA Medical Center, Gainesville, FL, USACardiothoracic Surgery Section, North Florida South Georgia VA Medical Center, Gainesville, FL, USADivision of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, Gainesville, USA Division of Infectious Diseases, North Florida South Georgia VA Medical Center, Gainesville, FL, USA Abstract Objective: To investigate a cluster of surgical site infections (SSIs) in patients who underwent coronary artery bypass graft (CABG) procedures, identify risk factors for infection, and implement measures to prevent new cases. Design: The investigation comprised a retrospective case–control study and an observational review of infection control practices between the fall of 2018 and 2019 (study period). Setting: Tertiary care medical center in Florida, USA. Patients: Patients who acquired an SSI following CABG during the study period were defined as case-patients. Control-patients were randomly selected patients who did not acquire a post-CABG SSI. Methods: We recorded clinical and epidemiologic details on a standardized form and analyzed data with SAS statistical software. Odds ratios and 95% confidence intervals were calculated. Results: Seven patients met the case definition and 21 control-patients were identified. While multiple variables were significant on univariate analysis, after controlling for confounding using multivariate analysis/logistic regression, only lower age (P < 0.0001) and meeting the requirements for appropriate perioperative temperature management (SCIP measure 10) (P = 0.01) were identified as independent risk factors for SSI. Per observational review, measures to reduce operating room traffic and limit door opening/closing were implemented and wound vacuum-assisted closure (VAC) use was phased out. Our institutional SSI rate returned to baseline and no additional clusters were seen in the following three years. Conclusions: Multiple potential risk factors exist for SSI after coronary artery bypass grafting. At our institution, minimizing operating room traffic and reducing wound VAC use may have successfully addressed these healthcare-associated infections. https://www.cambridge.org/core/product/identifier/S2732494X25001640/type/journal_article |
| spellingShingle | Alaina S. Ritter Vidya Kollu Amanda Aspilcueta Jennifer D. Connolly Eddie Manning Lennox Archibald A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center Antimicrobial Stewardship & Healthcare Epidemiology |
| title | A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center |
| title_full | A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center |
| title_fullStr | A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center |
| title_full_unstemmed | A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center |
| title_short | A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center |
| title_sort | retrospective case control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center |
| url | https://www.cambridge.org/core/product/identifier/S2732494X25001640/type/journal_article |
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