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To The Editor: We have read with interest the retrospective case series by Gruskay et al.1 evaluating the hypothesized relation between seasonal factors and the occurrence of surgical site infections (SSIs) following spinal surgery (Gruskay J, Smith J, Kepler CK, et al: The seasonality of postoperative infection in spine surgery. Clinical article. J Neurosurg Spine 18:57–62, January 2013). The authors found a significantly higher rate of SSIs during the summer and fall months and considered the postulated hypothesis as being correct. We believe, however, that the reported conclusion should be
Pull ter GunneAFHosmanAJCohenDBSchuetzMvan LaarhovenCJvan MiddendorpJJ: A methodological systematic review on surgical site infections following spinal surgery: part 1: risk factors. Spine (Phila Pa 1976)37:2017–20332012
PerencevichENMcGregorJCShardellMFurunoJPHarrisADMorrisJGJr: Summer peaks in the incidences of gram-negative bacterial infection among hospitalized patients. Infect Control Hosp Epidemiol29:1124–11312008