{
    "abstract": "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.\nThis 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.\nThere 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).\nLow preoperative serum albumin levels and abdominal hysterectomy are associated with increased risk of SSIs in HIV-infected women.",
    "authors": [
        {
            "affiliation": "Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: colemanj@jhmi.edu.",
            "firstname": "Jenell Sheree",
            "initials": "JS",
            "lastname": "Coleman"
        },
        {
            "affiliation": "Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.",
            "firstname": "Isabel",
            "initials": "I",
            "lastname": "Green"
        },
        {
            "affiliation": "Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.",
            "firstname": "Stacey",
            "initials": "S",
            "lastname": "Scheib"
        },
        {
            "affiliation": "Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.",
            "firstname": "Catherine",
            "initials": "C",
            "lastname": "Sewell"
        },
        {
            "affiliation": "Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.",
            "firstname": "Judy Mon-Hwa",
            "initials": "JM",
            "lastname": "Lee"
        },
        {
            "affiliation": "Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.",
            "firstname": "Jean",
            "initials": "J",
            "lastname": "Anderson"
        }
    ],
    "conclusions": "Low preoperative serum albumin levels and abdominal hysterectomy are associated with increased risk of SSIs in HIV-infected women.",
    "copyrights": "Copyright \u00a9 2014 Mosby, Inc. All rights reserved.",
    "doi": "10.1016/j.ajog.2013.08.037",
    "journal": "American journal of obstetrics and gynecology",
    "keywords": [
        "CD4 count",
        "human immunodeficiency virus",
        "hysterectomy",
        "preoperative albumin",
        "surgical site infection"
    ],
    "methods": null,
    "publication_date": "2013-09-04",
    "pubmed_id": "23999425",
    "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).",
    "title": "Surgical site infections after hysterectomy among HIV-infected women in the HAART era: a single institution's experience from 1999-2012.",
    "xml": "<Element 'PubmedArticle' at 0x788506ca29d0>"
}