Surgical Site Infection in a Tertiary Neonatal Surgery Centre

Woldemicael, Adiam Y.; Bradley, Sarah; Pardy, Caroline; Richards, Justin; Trerotoli, Paolo; Giuliani, Stefano

doi:10.1055/s-0038-1636916

Cited by 18 publications

(20 citation statements)

References 12 publications

(28 reference statements)

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“…We analyzed 10 comparative studies (Tables 2a,b) (16–18, 22, 24, 34, 45, 47, 51, 60). Among these articles, there were only two prospective cohort studies (45, 60) and one national prospective database (16). No randomized studies were included.…”

Section: Resultsmentioning

confidence: 99%

“…The meta-analysis of the 10 comparative studies (16–18, 22, 24, 34, 45, 47, 51, 60) showed that there was a slight albeit significant difference between neonates with and without SSI for gestational age (34.2 ± 2.4 weeks vs. 34.7 ± 2.3; p < 0.00001, MD −1.02, 95% CI [−1.22, −0.82], I 2 = 86%; Figure 2) and birth weight (2,171 ± 479 grams vs. 2,384 ± 411; p < 0.00001, MD −0.29, 95% CI [−0.35, −0.23], I 2 = 86%; Figure 3). Neonates with SSI were older at surgery compared to those without SSI (28.4 ± 24.4 days vs. 16.7 ± 14.3; p < 0.00001, MD 3.24, 95% CI [2.55, 3.93], I 2 = 98%; Figure 4).…”

Section: Resultsmentioning

confidence: 99%

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Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

et al. 2019

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Purpose: Surgical site infections (SSI) contribute to postoperative morbidity and mortality in children. Our aim was to evaluate the prevalence and identify risk factors for SSI in neonates. Methods: Using a defined strategy, three investigators searched articles on neonatal SSI published since 2000. Studies on neonates and/or patients admitted to neonatal intensive care unit following cervical/thoracic/abdominal surgery were included. Risk factors were identified from comparative studies. Meta-analysis was conducted according to PRISMA guidelines using RevMan 5.3. Data are (mean ± SD) prevalence. Results: Systematic review—of 885 abstracts screened, 48 studies (27,760 neonates) were included. The incidence of SSI was 5.6% (1,564 patients). SSI was more frequent in males (61.8%), premature babies (77.4%), and following gastrointestinal surgery (95.4%). Meta-analysis—10 comparative studies (16,442 neonates; 946 SSI 5.7%) showed that predictive factors for SSI development were gestational age, birth weight, age at surgery, length of surgical procedure, number of procedure per patient, length of preoperative hospital stay, and preoperative sepsis. Conversely, preoperative antibiotic use was not significantly associated with development of SSI. Conclusions: Younger neonates and those undergoing abdominal procedures are at higher risk for SSI. Given the lack of evidence-based literature, prospective studies may help determine the risk factors for SSI in neonates.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

et al. 2019

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“…17 Factors associated with an increased risk of SSI include; emergency procedures and longer duration of surgery. 18 Numerous risk factors are involved in SSI with a complex relationship as; surgery, patients, microbial, and environmentrelated factors. 18 The incidence rate of SSIs mainly depends upon the health care facility, surgical procedure, and level of care.…”

Section: Introductionmentioning

confidence: 99%

Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan

et al. 2020

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Globally, surgical site infections are one of the common infections which lead to a large amount of mortality and morbidity in postsurgical care. The risk for surgical site infection is multidimensional which includes mainly; patient, surgery, and hospital-related factors. This study is aimed to determine the burden of SSIs along with contributed risk factors. A prospective observational cross-sectional study was conducted in one of the largest public-sector hospitals in Pakistan. A total of 412 patients were recruited in the study with full consent and monitored for 30 days after surgery with direct and indirect surveillance. Overall, in seven different surgical procedures the incidence (29.8%) rate of SSI was observed; in appendectomy ( n = 17, 4.1%), exploratory laparotomy ( n = 51, 12.6%), laparoscopic cholecystectomy ( n = 12, 2.90%), mesh repair ( n = 17, 4.01%), thyroidectomy (5, 1.2%), transurethral resection of the prostate ( n = 11, 2.6%), and transurethral resection of the bladder (10, 2.4%). The average SSI rate in every single procedure was about 18 (4.27%) per surgical procedure out of 123 (29.85%) SSI cases. Types of SSI identified were superficial, deep incisional and organ/space ( n = 76, 18.4%, n = 23, 5.5%, and n = 24, 5.7%). Incidence of SSIs during admission, at readmission, and post-surveillance cases were ( n = 50, 12.1%, n = 25, 6.0% and n = 48, 11.6%). Associated risk factors found contributed to the incidence of SSI ( p < 0.05). Pre-operative ( n = 348, 84.5%) and 6 (1.5%) surgical patients did not received the post-operative antibiotics. The P. aeruginosa ( n = 15, 12.1%) and S. aureus (13, 10.5%). Cefoperazone and sulbactam were the most prescribed antibiotics. Associated risk factors and treatment outcomes of surgical patients have a direct association with the incidence of SSI. Hospital-based antimicrobial stewardship, implementation of surgical guidelines, patient care, and education are needed to develop at wards level in hospitals.

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“…The rates of adverse events in the population of hospitalized Canadian children have been measured at close to 10% with the highest rates seen in surgical patients [16]. Neonates are at particularly high risk with rates of surgical site infections reported as high as 13.5% [17,18]. The morbidity associated with these infections is reflected in a length of stay for these infants that is three times longer than the stay of their uninfected counterparts [17].…”

mentioning

confidence: 99%

“…Neonates are at particularly high risk with rates of surgical site infections reported as high as 13.5% [17,18]. The morbidity associated with these infections is reflected in a length of stay for these infants that is three times longer than the stay of their uninfected counterparts [17].…”

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confidence: 99%

Embracing change: the era for pediatric ERAS is here

et al. 2019

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The concept of Enhanced Recovery After Surgery (ERAS) has increasingly been embraced by our adult surgical colleagues, but has been slow to crossover to pediatric surgical subspecialties. ERAS ® improves outcomes through multiple, incremental steps that act synergistically throughout the entire surgical journey. In practice, ERAS ® is a strategy of perioperative management that is defined by strong implementation and ongoing adherence to a patient-focused, multidisciplinary, and multimodal approach. There are increasing numbers of surgical teams exploring ERAS ® in children and there is mounting evidence that this approach may improve surgical care for children across the globe. The first World Congress in Pediatric ERAS ® in 2018 has set the stage for a new era in pediatric surgical safety.

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Surgical Site Infection in a Tertiary Neonatal Surgery Centre

Cited by 18 publications

References 12 publications

Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan

Embracing change: the era for pediatric ERAS is here

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