Surgical site infection (SSI) following cardiac surgery poses a significant challenge for healthcare providers. Despite advances in surgical techniques and infection control measures, SSI remains a leading cause of morbidity and mortality, in addition to being a significant economic burden on healthcare services. Current literature suggests there is a reproducible difference in the incidence of SSI following cardiac surgery between sexes. We aim to assess the sex-specific predictive risk factors for sternal SSI following coronary artery bypass grafting (CABG) in addition to identifying any differences in the causative organisms between groups. Adult patients undergoing isolated CABG between January 2012 and December 2022 in one UK hospital organization were included. In this 10-year, retrospective observational study, a total of 10,208 patients met the inclusion criteria. Pre-operative risk factors were identified using univariate analysis. To assess dependence between sex and organism or Gram stain, a Pearson Chi-squared test with Yates correction for continuity was performed. In total there were 8457 males of which 181 developed a sternal SSI (2.14%) and 1751 females, 128 of whom had a sternal SSI (7.31%). Male patients were found to be significantly more likely to develop an SSI secondary to a Gram-positive organism, whereas female patients were more likely to have a Gram-negative causative organism (<0.00001). Staphylococcus was statistically more likely to be the causative organism genus in male patients. was found to be twice as common in the female cohort compared with the male group. In our study, we found a statistically significant difference in the causative organisms and Gram stain for post-CABG sternal SSIs between males and females. Male patients predominately have Gram-positive associated SSIs, whereas female SSI pathogens are more likely to be Gram negative. The preoperative risk profiles of both cohorts are similar, including being an insulin-dependent diabetic and triple vessel coronary artery disease. Given these findings, it prompts the question, should we be tailoring our SSI treatment strategies according to sex and associated risk profiles?

中文翻译：

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冠状动脉旁路移植术后手术部位感染的性别差异：一项回顾性观察研究

心脏手术后的手术部位感染 (SSI) 对医疗保健提供者构成了重大挑战。尽管手术技术和感染控制措施取得了进步，SSI 仍然是发病率和死亡率的主要原因，并且给医疗保健服务带来了巨大的经济负担。目前的文献表明，不同性别心脏手术后 SSI 的发生率存在可重复的差异。我们的目的是评估冠状动脉旁路移植术 (CABG) 后胸骨 SSI 的性别特异性预测危险因素，以及确定各组之间致病微生物的差异。 2012 年 1 月至 2022 年 12 月期间在英国一家医院组织接受孤立 CABG 的成年患者被纳入研究。在这项为期 10 年的回顾性观察研究中，共有 10,208 名患者符合纳入标准。使用单变量分析确定术前危险因素。为了评估性别和生物体或革兰氏染色之间的依赖性，进行了皮尔逊卡方检验和耶茨连续性校正。总共有 8457 名男性，其中 181 名发生胸骨 SSI（2.14%），1751 名女性，其中 128 名发生胸骨 SSI（7.31%）。研究发现，男性患者更容易发生继发于革兰氏阳性菌的 SSI，而女性患者更可能患有革兰氏阴性菌 (<0.00001)。从统计上看，葡萄球菌更有可能是男性患者的致病菌属。研究发现，女性群体的发病率是男性群体的两倍。在我们的研究中，我们发现男性和女性之间 CABG 后胸骨 SSI 的致病微生物和革兰氏染色存在统计学上的显着差异。男性患者主要患有革兰氏阳性相关 SSI，而女性 SSI 病原体更有可能是革兰氏阴性。两个队列的术前风险状况相似，包括胰岛素依赖型糖尿病和三支冠状动脉疾病。鉴于这些发现，这就提出了一个问题：我们是否应该根据性别和相关风险状况来调整我们的 SSI 治疗策略？