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Surgical Site Infection after Renal Transplantation

Published online by Cambridge University Press:  20 January 2015

Anthony D. Harris ,
Brandon Fleming ,
Jonathan S. Bromberg ,
Peter Rock ,
Grace Nkonge ,
Michele Emerick ,
Michelle Harris-Williams  and
Kerri A. Thom
Anthony D. Harris
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
Brandon Fleming
Affiliation:
University of Maryland School of Pharmacy, Baltimore, Maryland
Jonathan S. Bromberg
Affiliation:
Departments of Surgery and Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland
Peter Rock
Affiliation:
Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, Maryland
Grace Nkonge
Affiliation:
Department of Infection Prevention and Healthcare Epidemiology at the University of Maryland Medical Center, Baltimore, Maryland
Michele Emerick
Affiliation:
Department of Infection Prevention and Healthcare Epidemiology at the University of Maryland Medical Center, Baltimore, Maryland
Michelle Harris-Williams
Affiliation:
Department of Infection Prevention and Healthcare Epidemiology at the University of Maryland Medical Center, Baltimore, Maryland
Kerri A. Thom*
Affiliation:
Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland
*
Address correspondence to Kerri A. Thom, MD, MS, 685 W Baltimore Street, MSTF Suite 334B, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland 21201 (kthom@epi.umaryland.edu).
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Abstract

OBJECTIVE

To identify factors associated with the development of surgical site infection (SSI) among adult patients undergoing renal transplantation

DESIGN

A retrospective cohort study

SETTING

An urban tertiary care center in Baltimore, Maryland, with a well-established renal transplantation program that performs ~200–250renal transplant procedures annually

RESULTS

At total of 441 adult patients underwent renal transplantation between January 1, 2010, and December 31, 2011. Of these 441patients, 66 (15%) developed an SSI; of these 66, 31 (47%) were superficial incisional infections and 35 (53%) were deep-incisional or organ-space infections. The average body mass index (BMI) among this patient cohort was 29.7; 84 (42%) were obese (BMI >30). Patients who developed an SSI had a greater mean BMI (31.7 vs 29.4; P=.004) and were more likely to have a history of peripheral vascular disease, rheumatologic disease, and narcotic abuse. History of cerebral vascular disease was protective. Multivariate analysis showed BMI (odds ratio [OR] 1.06; 95% confidence interval [CI], 1.02–1.11) and past history of narcotic use/abuse (OR, 4.86; 95% CI, 1.24–19.12) to be significantly associated with development of SSI after controlling for National Healthcare Surveillance Network (NHSN) score and presence of cerebrovascular, peripheral vascular, and rheumatologic disease.

CONCLUSIONS

We identified higher BMI as a risk factor for the development of SSI following renal transplantation. Notably, neither aggregate comorbidity scores nor NHSN risk index were associated with SSI in this population. Additional risk adjustment measures and research in this area are needed to compare SSIs across transplant centers.

Infect Control Hosp Epidemiol 2015;00(0): 1–7

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 36 , Issue 4 , April 2015 , pp. 417 - 423
Copyright
© 2015 by The Society for Healthcare Epidemiology of America. All rights reserved 

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