Increasing Methicillin‐Resistant Staphylococcus aureus Burden in 90‐Day Groin Surgical Site Infection After Femoral Arterial Exposure: A 15‐Year Single‐Centre Cohort Study

Groin surgical site infection remains common after femoral arterial exposure (clean wound class I), yet long-term data on temporal trends and microbiological shifts are limited. This retrospective study reviewed all consecutive groin incisions for femoral arterial exposure at a tertiary vascular centre (2010-2024); only groin-site infections were counted. A study-defined 90-day surveillance window was used. Temporal trends were assessed using mixed-effects logistic regression. Among 8742 incisions in 7218 patients, 846 (9.7%) developed infection: 490 superficial (57.9%), 245 deep (29.0%) and 111 organ/space (13.1%). Calendar year was not associated with infection after adjustment (adjusted odds ratio 1.00; 95% confidence interval 0.98-1.03). Independent predictors included diabetes, obesity, renal insufficiency, immunosuppressive therapy and prosthetic material. The methicillin-resistant Staphylococcus aureus proportion among 724 culture-positive episodes rose from 8.7% (2010-2014) to 21.0% (2020-2024; p < 0.001), persisting after adjustment for infection depth and procedure mix. Infection incidence remained stable while the microbiological profile shifted toward higher methicillin-resistant Staphylococcus aureus burden. Antibiogram review and prophylaxis reassessment within an antimicrobial-stewardship framework are warranted.