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A retrospective case–control study of a cluster of surgical site infections after coronary artery bypass grafting at a tertiary medical center

Year: 2025

Type: article

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.

Source: Antimicrobial Stewardship & Healthcare Epidemiology

DOI: 10.1017/ash.2025.164

Authors: Alaina S. Ritter, Vidya Kollu, Amanda Aspilcueta, Jennifer D. Connolly, Eddie Manning, Lennox Archibald

Institutions: University of Florida Health, University of Florida, North Florida/South Georgia Veterans Health System, Malcom Randall VA Medical Center

Language: English

Topic: Surgical site infection prevention

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,719