Risk factors for Staphylococcus aureus surgical site infection during an outbreak in patients undergoing cardiovascular surgery

Am J Infect Control. 2013 Jun;41(6):509-12. doi: 10.1016/j.ajic.2012.07.016. Epub 2012 Dec 21.

Abstract

Background: This study examined the epidemiology of an outbreak of Staphylococcus aureus surgical site infections (SSI) after cardiovascular surgery, and analyzed risk factors for S aureus SSIs.

Methods: This was a retrospective case-control study to determine risk factors for S aureus SSI in 38 patients who developed S aureus SSI during the outbreak period, compared with age-, sex-, and procedure-matched controls. S aureus strains were typed by pulsed-field gel electrophoresis.

Results: A total of 38 patients had S aureus SSI. Pulsed-field gel electrophoresis identified transmission of 3 S aureus clones (2 MSSA clones and 1 MRSA clone). Twenty-one health care workers were carriers of outbreak strains. In multivariate analysis, the significant risk factors for S aureus SSI were previous cardiac surgery (odds ratio, 7.41; 95% confidence interval, 1.05-52.16) and long procedure duration (odds ratio, 1.49; 95% confidence interval, 1.00-2.21).

Conclusions: This outbreak demonstrates evidence of nosocomial transmission of 3 clones of S aureus in the setting of incomplete compliance with recommended standard perioperative infection control measures, associated with a high prevalence of staff carriage of the predominant outbreak strains.

MeSH terms

  • Aged
  • Canada / epidemiology
  • Cardiovascular Surgical Procedures / adverse effects
  • Cardiovascular Surgical Procedures / statistics & numerical data
  • Case-Control Studies
  • Causality
  • Cross Infection / epidemiology*
  • Cross Infection / prevention & control*
  • Disease Outbreaks / prevention & control*
  • Female
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus / isolation & purification
  • Middle Aged
  • Retrospective Studies
  • Risk Factors
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / prevention & control
  • Surgical Wound Infection / epidemiology*
  • Surgical Wound Infection / microbiology