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Seasonal Variation of Common Surgical Site Infections: Does Season Matter?

Published online by Cambridge University Press:  26 May 2015

Michael J. Durkin
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina Durham Veterans Affairs Medical Center, Durham, North Carolina
Kristen V. Dicks
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Arthur W. Baker
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Sarah S. Lewis
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Rebekah W. Moehring
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina Durham Veterans Affairs Medical Center, Durham, North Carolina
Luke F. Chen
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Daniel J. Sexton
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Deverick J. Anderson
Affiliation:
Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina Duke Program for Infection Prevention and Healthcare Epidemiology, Durham, North Carolina
Corresponding

Abstract

OBJECTIVE

To evaluate seasonal variation in the rate of surgical site infections (SSI) following commonly performed surgical procedures.

DESIGN

Retrospective cohort study.

METHODS

We analyzed 6 years (January 1, 2007, through December 31, 2012) of data from the 15 most commonly performed procedures in 20 hospitals in the Duke Infection Control Outreach Network. We defined summer as July through September. First, we performed 3 separate Poisson regression analyses (unadjusted, multivariable, and polynomial) to estimate prevalence rates and prevalence rate ratios of SSI following procedures performed in summer versus nonsummer months. Then, we stratified our results to obtain estimates based on procedure type and organism type. Finally, we performed a sensitivity analysis to test the robustness of our findings.

RESULTS

We identified 4,543 SSI following 441,428 surgical procedures (overall prevalence rate, 1.03/100 procedures). The rate of SSI was significantly higher during the summer compared with the remainder of the year (1.11/100 procedures vs 1.00/100 procedures; prevalence rate ratio, 1.11 [95% CI, 1.04–1.19]; P=.002). Stratum-specific SSI calculations revealed higher SSI rates during the summer for both spinal (P=.03) and nonspinal (P=.004) procedures and revealed higher rates during the summer for SSI due to either gram-positive cocci (P=.006) or gram-negative bacilli (P=.004). Multivariable regression analysis and sensitivity analyses confirmed our findings.

CONCLUSIONS

The rate of SSI following commonly performed surgical procedures was higher during the summer compared with the remainder of the year. Summer SSI rates remained elevated after stratification by organism and spinal versus nonspinal surgery, and rates did not change after controlling for other known SSI risk factors.

Infect. Control Hosp. Epidemiol. 2015;36(9):1011–1016

Type
Original Articles
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

Presented in part: IDWeek 2014; Philadelphia, Pennsylvania; October 10, 2014 (Abstract 47427). A subset of this data (<15%; specifically including laminectomy and spinal fusion procedures) was analyzed and published by the Journal of Neurosurgery: Spine.

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