Is undernutrition prognostic of infection complications in children undergoing surgery? A systematic review

Abstract

Background: Healthcare-associated infections are costly and are increasingly viewed as an indicator of the quality of care. Although strategies to reduce infections have become widespread, few studies have formally investigated the role of undernutrition on the development of infection-related complications in children after surgery. Aim: To perform a systematic review of the literature to determine if undernutrition is prognostic of postoperative infection complications in children. Methods: Electronic bibliographic and research databases were searched from 1950 to 2014. Inclusion criteria were studies in children (age <18 years) evaluating pre-operative nutritional status and reporting postoperative infection complications. Quality assessment was performed independently by two reviewers, with disagreements resolved by a third reviewer. The quality of the evidence was judged to be low in the majority of studies. Findings: Ten cohort and two caseecontrol studies met the inclusion criteria. Five studies reported an outcome combining infection-related complications, with the remainder reporting individual infection complications. Six studies reported surgical site infection (SSI) alone or in combination with other infection complications. Direct comparison between studies was difficult due to clinical and diagnostic heterogeneity. Unadjusted analyses (for patient or clinical variables) were suggestive of a relationship between undernutrition and infection complications. In studies controlling for other variables, the analyses did not remain significant for SSI. Conclusion: There was low-quality evidence that undernutrition may be predictive of postoperative infection complications in children, with the exception of SSI. However, inconsistencies in nutritional and outcome assessments made it difficult to draw conclusions. Larger, high-quality studies are warranted to further investigate a potential prognostic relationship. ª

Multidrug-resistant gram-negative bacterial infections in a teaching hospital in Ghana

“…The geriatric and pediatric patients are usually more disposed to infections due to their immune status. The advancing age are commonly associated with risk factors including reduced immunity, co-morbid diseases such as diabetes mellitus, chronic heart diseases, neurogenic bladder [ 13 , 16 ] whilst in infants, lack of fully developed immunity, malnutrition as well as inadequate hygiene [ 17 ] put them at greater risk of infections. Urinary tract infection (34.5%) was most prevalent within the period of our study, and is comparable to 31.5% reported from a study on prevalence and antibiotic susceptibility pattern of uropathogens conducted in secondary hospital in Ghana [ 18 ].…”

Is malnutrition associated with orthopaedic infections? A single-centre pilot evaluation

“…Malnutrition is frequent among adult surgical patients [1][2][3]. Some authors suggest that 28 malnutrition may be an independent risk factor for orthopedic infections.…”

Multidrug-Resistant Acinetobacter baumannii Infections in a Cardiovascular Surgery Intensive Care Unit: Risk Factors and Outcome Predictors

“…The pediatric and geriatric patients are usually more disposed to infections due to their immune status. The advancing age are commonly associated with risk factors including reduced immunity, co-morbid diseases such as chronic heart diseases, diabetes mellitus, neurogenic bladder [12,13] whilst in infants, lack of fully developed immunity, malnutrition as well as inadequate hygiene [14] put them at greater risk of infections. In a study conducted in Ghana, urinary tract infection was 31% [15].Respiratory system diseases,DM,renal diseases,HL,HT were in our patients risk factors.…”