Surgical site infections after hysterectomy among HIV-infected women in the HAART era: A single institution's experience from 1999-2012

Jenell Sheree Coleman, Isabel Green, Stacey Scheib, Catherine Sewell, Judy Mon Hwa Lee, Jean Anderson

Research output: Contribution to journalArticle

Abstract

Objective We sought to determine risk factors associated with surgical site infection (SSI) among a cohort of human immunodeficiency virus (HIV)-infected women undergoing hysterectomy during the era of highly active antiretroviral therapy. Study Design This is a retrospective study of HIV-infected women who underwent a hysterectomy for benign indications at a tertiary care center. Electronic medical records were reviewed from January 1999 through December 2012. SSI was defined using Centers for Disease Control and Prevention criteria. Results There were 77 HIV-infected women who underwent a hysterectomy: 47 (61%) were abdominal; 16 (21%) were laparoscopic or robot-assisted; and 14 (18%) were vaginal. Acquired immune deficiency syndrome was diagnosed in 58% of patients, and 75% of patients self-reported use of highly active antiretroviral therapy at the time of surgery. There were 17 (22%) SSIs; 5 (29%) superficial incisional wound infections, 3 (18%) vaginal cuff cellulitis, and 9 (53%) pelvic abscesses were diagnosed. After multivariable logistic regression, preoperative albumin level (adjusted odds ratio [aOR], 0.14; 95% confidence interval [CI], 0.02-0.86) and minimally invasive hysterectomy (aOR, 0.16; 95% CI, 0.03-0.84) were associated with decreased SSI. Preoperative absolute CD4 count was not associated with SSI (aOR, 0.99; 95% CI, 0.99-1). Conclusion Low preoperative serum albumin levels and abdominal hysterectomy are associated with increased risk of SSIs in HIV-infected women.

Original languageEnglish (US)
Pages (from-to)117.e1-117.e7
JournalAmerican journal of obstetrics and gynecology
Volume210
Issue number2
DOIs
StatePublished - Feb 2014

Keywords

  • CD4 count
  • human immunodeficiency virus
  • hysterectomy
  • preoperative albumin
  • surgical site infection

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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