Addressing an increase in surgical site infections during the COVID-19 pandemic-Identifying opportunities during a chaotic time

Background: Health care systems saw increases in device-associated infections and decreases in surgical site infections (SSI) during the COVID-19 pandemic. However, following an increase in SSIs, an acute care hospital assessed the risk and preventative factors of SSIs among patients. Methods: A retrospective cohort study on surgeries performed between January 2020 and September 2021 analyzed associations of SSI with risk and preventive factors utilizing chi 2, t-tests, and odds ratios. A secondary analysis was utilized to determine the association of case urgency and prevention practice performance. Results: There was a significant difference in the administration of correct perioperative antibiotic selection between SSI (78.1%) and non-SSI (86.2%) along with 2.9 greater odds of developing an SSI with incorrect perioperative antibiotics. Patients who had urgent cases were significantly less likely than elective to receive preoperative chlorhexidine gluconate wipes (81.6%, 61.5%, respectively), correct antibiotic selection and timing (93.2%, 70.8%, respectively) and chlorhexidine and alcohol skin preparation (81.6%, 67.5%, respectively).Discussion: Disruption of perioperative workflow during the COVID-19 pandemic likely resulted in an increase in SSI. Numerous opportunities were identified for focused prevention efforts. Conclusions: The next steps include implementing strategies to improve SSI prevention and establish a culture that can withstand workflow disruptions to maintain a safe environment during significant changes. (c) 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Automated summary

This study retrospectively assessed the risk and preventive factors of surgical site infections during the COVID-19 pandemic. It found issues with perioperative antibiotic selection and higher risk for patients with urgent cases in terms of preventive measures. The study suggests implementing strategies to improve SSI prevention and establishing a culture that can withstand workflow disruptions during significant changes.