ArticleInfection prevention in practice2026
Epidemiological characteristics and non-linear risk factors of surgical site infections in patients with cancer: a propensity score-matched case-control study.
Article in Infection prevention in practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Surgical site infection (SSI) imposes a significant burden on patients with cancer, yet comprehensive studies on the cancer-specific SSI remain limited. Methods: A case-control study analysed SSI epidemiology in 20,370 cancer patients who underwent surgery at a specialized hospital in Shandong Province, China, between 2021 and 2023, using propensity score matching (PSM) to adjust for confounders. Multi-variable conditional logistic regression and restricted cubic splines (RCS) were used to identify risk factors and non-linear associations. Results: SSI incidence was 1.23%, predominating in males, class II wounds, organ/space SSI, and colorectal surgery. Microbiological testing recovered 277 pathogens, mainly Gram-negative bacteria (67.1%). Gram-negative isolates showed high resistance to ampicillin and cephalosporins, while carbapenems and amikacin remained effective. Independent risk factors were body mass index (BMI) (adjusted odds ratio [aOR]: 1.090), postoperative antibiotic therapy (aOR: 3.662), and prolonged postoperative antibiotic therapy (aOR: 1.214). Protective factors included extended pre-operative antibiotic therapy on the day of surgery (aOR: 0.958) and elective surgery (aOR: 0.325). A non-linear relationship appeared between SSI risk and pre-operative white blood cell (WBC) counts. SSI risk increased linearly with BMI above 25 kg/m Conclusion: In cancer patients, SSI is mainly caused by Gram-negative bacteria resistant to ampicillin and cephalosporins. Risk factors included higher BMI, prolonged surgery, and postoperative antibiotic use, whereas pre-operative antibiotic therapy on the day of surgery and elective surgery was protective. A non-linear relationship was observed between SSI risk and pre-operative WBC counts. These findings inform prevention strategies but require validation in multi-centre prospective studies.
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