Surgical site infection (SSI) imposes a significant burden on patients with cancer, yet comprehensive studies on the cancer-specific SSI remain limited. A case-control study analyzed SSI epidemiology in 20370 cancer patients who underwent surgery at a specialized hospital in Shandong Province, China, between 2021 and 2023, using propensity score matching (PSM) to adjust for confounders. Multivariable conditional logistic regression and restricted cubic splines (RCS) were used to identify risk factors and nonlinear associations. SSI incidence was 1.23%, predominating in males, Class II wounds, organ/space SSI, and colorectal surgery. Microbiological testing recovered 277 pathogens, mainly gram-negative bacteria (67.1%). Gram-negative isolates showed high resistance to ampicillin and cephalosporins, while carbapenems and amikacin remained effective. Independent risk factors were BMI (adjusted odds ratio aOR: 1.090), postoperative antibiotic therapy (aOR: 3.662), and prolonged postoperative antibiotic therapy (aOR: 1.214). Protective factors included extended preoperative antibiotic therapy on the day of surgery (aOR: 0.958) and elective surgery (aOR: 0.325). A nonlinear relationship appeared between SSI risk and preoperative white blood cell (WBC) counts. SSI risk increased linearly with BMI above 25 kg/m 2 and operative time exceeding 161 minutes. In cancer patients, SSI is mainly caused by gram-negative bacteria resistant to ampicillin and cephalosporins. Risk factors included higher BMI, prolonged surgery, and postoperative antibiotic use, whereas preoperative antibiotic therapy on the day of surgery and elective surgery were protective. A nonlinear relationship was observed between SSI risk and preoperative WBC counts. These findings inform prevention strategies but require validation in multicenter prospective studies.
Ma et al. (Wed,) studied this question.