title: Temporal trends in the incidence of surgical site infections in patients undergoing coronary artery bypass graft surgery: a population-based cohort study, 1993 to 2008.
abstract: OBJECTIVE
  To determine the incidence of and temporal trends in surgical site infections (SSIs) in patients undergoing coronary artery bypass graft (CABG) surgery.
  
  
  METHODS
  A population-based cohort study was conducted to describe the epidemiologic features of SSI in Olmsted County, Minnesota, between January 1, 1993, and December 31, 2008, using the Rochester Epidemiology Project. Period-specific incidence rates (in-hospital or within 30 days outside the hospital) were calculated. Logistic regression analysis was used to adjust for potential confounders that could affect temporal trends in SSI incidence rates.
  
  
  RESULTS
  During the 16-year study, of 1424 residents of Olmsted County who underwent CABG surgery, 1189 (83%) had isolated CABG and 235 (17%) had combined CABG and valve surgery. The overall SSI incidence rate was 7.0% (95% confidence interval [CI], 5.7%-8.4%). The incidence rate of superficial sternal SSI was 2.0% (95% CI, 1.2%-2.7%) and of deep sternal SSI was 1.5% (95% CI, 0.9%-2.2%). The leg harvest site infection rate was 3.6% (95% CI, 2.6 %-4.5%). The incidence rate decreased over time with a statistically significant linear trend. The adjusted odds ratio (95% CI) of SSI showed a decreasing linear trend: 0.39 (0.19-0.81) vs 0.50 (0.27-0.93) vs 0.83 (0.48-1.42) vs reference for 2005-2008 vs 2001-2004 vs 1997-2000 vs 1993-1996.
  
  
  CONCLUSIONS
  In this population-based surveillance study of patients undergoing CABG surgery, the incidence of SSI decreased markedly between 1993 and 2008 in patients in Olmsted County. The factors responsible for this decrease are the focus of ongoing investigations.
authors.affiliation: Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA. faalasmari@kfmc.med.sa
authors.forename: Faisal A
authors.initials: FA
authors.lastname: Alasmari
authors.forename: Imad M
authors.initials: IM
authors.lastname: Tleyjeh
authors.forename: Muhammad
authors.initials: M
authors.lastname: Riaz
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Greason
authors.forename: Elie F
authors.initials: EF
authors.lastname: Berbari
authors.forename: Abinash
authors.initials: A
authors.lastname: Virk
authors.forename: Larry M
authors.initials: LM
authors.lastname: Baddour
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000706:statistics & numerical data*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D016017:Odds Ratio; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013530:Surgical Wound Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control