Surgical site infections following spinal surgery at a tertiary care center in Lebanon: Incidence, microbiology, and risk factors

Surgical site infections (SSIs) following spinal surgery are associated with significant morbidity and long-term complications. The epidemiology of these infections has not been previously studied in Lebanon. This nested case-control study was conducted between 2001 and 2003 at the American University of Beirut Medical Center. Cases were defined as patients who developed surgical site infection within 30 d of surgery. Controls were patients with no evidence of infection. There were 27 cases of surgical site infections among 997 surgeries with an incidence of 2.7%. Compared to controls, cases were older (mean age 59 vs 47 y, p = 0.001), and were more likely to have diabetes (OR = 4.0; 95% CI 1.2 - 12.8) and foreign body implantation (OR = 3.4; 95% CI 1.3 - 9.3). Antibiotic prophylaxis was given for a range of 0 - 6 d in cases and 0 - 7 d in controls. Coagulase-negative staphylococci were the most commonly isolated organisms. Hospital stay was significantly longer in cases than controls. The rates of surgical site infections following spinal surgery at our center are comparable to worldwide rates. There is unjustified overuse of prophylactic antibiotics in our patients that has the potential of inducing emergence of antimicrobial resistance.