title: Epidemiology and outcomes of surgical site infections following orthopedic surgery.
abstract: BACKGROUND
  Surgical site infections (SSIs) are common complications after surgeries, usually leading to increased health care costs. Therefore, we evaluated the efficiency of current preoperative antibiotic prophylaxis and risk factors of SSIs in the orthopedic wards in a major teaching hospital in China.
  
  
  METHODS
  We retrospectively reviewed a population of 2,061 patients who underwent orthopedic surgeries between January 2010 and January 2012 and examined the bacterial isolates and their resistance patterns associated with orthopedic infections. Moreover, a multivariate logistic regression was used to identify independent risk factors for SSIs.
  
  
  RESULTS
  Thirty-three out of the 45 clinical SSIs were culture positive, and a total of 35 bacterial strains was isolated, among which, 65.72% (n= 23) were gram-positive isolates, and 34.28% (n = 12) were gram-negative bacteria. Significantly, 68.6% of all bacterial isolates were resistant to cefuroxime. Additionally, this study found that diabetes mellitus (odds ratio [OR], 7.539), smoking (OR, 2.378), duration of surgeries longer than 3 hours (OR, 3.633), absence of antibiotic prophylaxis (OR, 6.562), and previous operations (OR, 2.190) were crucial independent risk factors associated with a significant increase in the development rate of SSIs following orthopedic incisional operations.
  
  
  CONCLUSIONS
  Our data suggested that appropriate modifications to antibiotic prophylaxis regimens should be considered. Furthermore, tightening glucose control, stopping smoking, providing proper antibiotic prophylaxis, and shortening surgery time are promising approaches to reduce the SSIs rate.
authors.affiliation: School of Pharmaceutical Sciences, Shandong University, Jinan, China.
authors.forename: Guo-qing
authors.initials: GQ
authors.lastname: Li
authors.forename: Fang-fang
authors.initials: FF
authors.lastname: Guo
authors.forename: Yang
authors.initials: Y
authors.lastname: Ou
authors.forename: Guang-wei
authors.initials: GW
authors.lastname: Dong
authors.forename: Wen
authors.initials: W
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis / Q000379:methods; D001424:Bacterial Infections / Q000453:epidemiology* / Q000628:therapy*; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Bacterial isolates; Orthopedics; Risk factors; Surgical wound infection