ABSTRACT Background: Surgical site infection (SSI) continues to be a global health problem that causes increased morbidity and mortality, especially in developing countries. Objective: This study aimed to determine the prevalence of SSI, the microbial pathogens and their resistance patterns, as well as to identify risk factors associated with this infection at a Saudi tertiary care hospital. Methods: This cross-sectional observational study involved all patients who had surgery and who stayed in the hospital for at least 48 h during a one-year period. SSI was diagnosed using the guidelines of the Centers for Disease Control and Prevention. Results: A total of 2160 patients were included and the overall SSI rate was 10.2%. Malignancy (OR = 1.63), duration of operation (OR = 1.41), high ASA score (OR = 1.8), and clean-contaminated (OR = 1.5) and contaminated operations (OR = 3.2) were found to be statistically significant risk factors for SSI. The most frequently isolated microorganisms were Acinetobacter spp. (31.5%), E. coli (25.5%) and Pseudomonas spp. (17.9%). Conclusions: This study further illustrates the burden of SSI in a typical hospital situation in developing countries. Our findings highlight the urgent need to develop a consistent national surveillance program for SSI with accurate feedback of appropriate data to help surgeons control and reduce the SSI rates in developing countries. Keywords: Surgical site infection - surveillance - contaminated wounds - Acinetobacter spp.

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