Surgical site infection incidence and surgical antibiotic prophylaxis in the intensive care unit (ICU) patient: a multicenter observational study
Authors' conclusion
SSI affects more than one in five critically ill patients. After adjustment for prespecified confounders, the association with broad-spectrum therapy likely reflected confounding by indication, whereas the absence of any antimicrobial coverage was independently associated with increased SSI risk.
Study context
- Population
- Adults (≥18 years) with ICU stay ≥ 48 h who underwent surgery during their ICU stay, five French ICUs (March 2022-March 2023)
- Participants
- 338 adults · 5 ICUs
- Exposure
- Broad-spectrum or no antimicrobial vs narrow-spectrum antimicrobials
- Outcome
- SSI incidence after surgery
Methodological detailsmulticentre, generalized estimating equations with prespecified adjustment set
- Multicentre
- Generalized estimating equations with prespecified adjustment set
Main finding
As reported in the abstract
SSI incidence
Each group vs narrow-spectrumOdds ratio (95% CI)P value
Broad-spectrum
3.06(1.63–5.76)
P < 0.001No antimicrobial
2.49(1.01–6.15)
P = 0.048- Overall surgical site infection (SSI) incidence
- 21%
Observational data: associations, not effects.
Further findings
SSI incidence by PATOS (subgroup)
- SSI incidence by present at time of surgery (PATOS) (subgroup): PATOS n = 52, 15%
Stratified analysis (PATOS-positive and trauma subgroups)
- Antimicrobial spectrum also had significant effect on SSI risk in PATOS-positive and trauma patients
Outcomes associated with SSI
- SSI associated with prolonged ICU/hospital LOS, increased organ support use, and worse outcomes at day 28 and day 90
Original publication
Surgical site infection incidence and surgical antibiotic prophylaxis in the ICU patient: a multicenter observational study. J Intensive Care. Published 24 July 2026. doi:10.
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