Prevalence of Surgical Site Infection (SSI) and Its Association With Vitamin D Deficiency.

Abstract

Surgical site infections (SSIs) are one of the significant complications detected after surgical procedures. Recent studies have highlighted the antimicrobial, wound-healing, and immunological properties of vitamin D. Therefore, this study examined the association between levels of preoperative vitamin D and SSI occurrence in Saudi Arabia. We conducted this retrospective observational study among patients who underwent surgery at King Faisal Medical Complex, Saudi Arabia. We included data from patients who underwent surgery between January 2021 and October 2023 in the study. If vitamin D concentrations were not measured at admission, patients were excluded from the final analysis. The researchers performed statistical analysis using the computer program Statistical Package for Social Sciences (SPSS), version 26.0 (IBM Corp., Armonk, NY). The significant level was considered when the p-value was less than 0.05. The study included 130 patients with a mean (SD) age of 26.98 (9.3) years. Most patients were females (n = 92, 70.8%), had diabetes mellitus disease (n = 121, 93.1%), had a vitamin D deficiency (<30 ng/dl) (n = 106, 81.5%), and underwent cesarean section (n = 80, 61.5%). The mean (SD) vitamin D level among patients was 19.9 (9.7) ng/dl, and the mean (SD) hemoglobin level was almost normal (12.30 (2.1) g/dl). Out of 40.8% (n = 53) of patients, the most detected pathogenic bacteria was Escherichia coli, followed by Staphylococcus aureus (n = 11, 44%, and n = 7, 25%, respectively). Furthermore, vitamin D deficiency significantly impacted positive SSI; patients with insufficient levels had a higher infection rate compared to those with sufficient levels (n = 58, 54.7% vs. n = 7, 29.2%, p-value = 0.024). A longer surgery duration did not increase the risk of SSI (p-value = 0.047). Patients with class 3 wounds were more prone to SSI than those with class 2 wounds (n = 12, 100% vs. n = 53, 44.9%, p-value<0.001). This study provides important evidence supporting the relationship between vitamin D deficiency and SSI incidence. Patients with lower levels of vitamin D reported a higher incidence of SSIs. Healthcare providers should pay attention to the high prevalence of vitamin D deficiency among patients undergoing surgery. Screening for vitamin D deficiency and implementing convenient interventions to optimize vitamin D levels could help reduce the incidence of SSIs. Further research with larger sample sizes, more diverse populations, and different surgery types is necessary to validate these findings and explore additional factors influencing SSI development.