Surgical site infections in a longitudinal cohort of neonatal intensive care unit patients

J Perinatol. 2016 Apr;36(4):300-5. doi: 10.1038/jp.2015.191. Epub 2015 Dec 10.

Abstract

Objective: To estimate the incidence and identify risk factors for surgical site infections (SSIs) among infants in the neonatal intensive care unit (NICU).

Study design: A prospective cohort study of infants undergoing surgical procedures from May 2009 to April 2012 in three NICUs was performed. SSI was identified if documented by an attending neonatologist and treated with intravenous antibiotics. Independent risk factors were identified using logistic regression, adjusting for NICU.

Result: A total of 902 infants underwent 1346 procedures and experienced 60 SSIs (incidence: 4.46/100 surgeries). Risk factors for SSIs included younger chronological age (odds ratio (OR) 1.03 per day decrease, 95% confidence interval (CI) 1.01, 1.04), lower gestational age (OR 1.09 per week decrease, CI 1.02, 1.18), male sex (OR 1.17, CI 1.04, 1.34) and use of central venous catheter (OR 4.40, CI 1.19, 9.62). Only 43% had surgical site cultures obtained and Staphylococcus aureus was most commonly isolated.

Conclusion: SSIs complicated 4.46% of procedures performed in the NICU. Although few modifiable risk factors for SSIs were identified, future efforts should focus on evaluating the impact of current prevention strategies on the incidence of neonatal SSI.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cefazolin / therapeutic use
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Intensive Care Units, Neonatal*
  • Length of Stay
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Risk Factors
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / epidemiology*
  • Staphylococcus aureus / isolation & purification
  • Surgical Wound Infection / drug therapy
  • Surgical Wound Infection / epidemiology*
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Vancomycin
  • Cefazolin