Surgery-Associated Infections among Infants Born Extremely Preterm - 21/12/21
, Nellie I. Hansen, MPH 2, Mohannad Moallem, MD 3, Myra H. Wyckoff, MD 4, Pablo J. Sánchez, MD 3, Barbara J. Stoll, MD 1, 5for the
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network∗
Abstract |
Objective |
To assess the burden of invasive infection following surgery (surgery-associated infections [SAI]) among infants born extremely premature.
Study design |
This was an observational, prospective study of infants born at gestational age 22-28 weeks hospitalized for >3 days, between April 1, 2011, to March 31, 2015, in academic centers of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. SAI was defined by culture-confirmed bacteremia, fungemia, or meningitis ≤14 days following a surgical procedure.
Results |
Of 6573 infants, 1154 (18%) who underwent surgery were of lower gestational age (mean [SD]: 25.5 [1.6] vs 26.2 [1.6], P < .001), lower birth weight (803 [220] vs 886 [244], P < .001), and more likely to have a major birth defect (10% vs 3%, P < .001); 64% had 1 surgery (range 1-10 per infant). Most underwent gastrointestinal procedures (873, 76%) followed by central nervous system procedures (150, 13%). Eighty-five (7%) infants had 90 SAIs (78 bacteremia, 5 fungemia, 1 bacteremia and meningitis, 6 meningitis alone). Coagulase-negative staphylococci were isolated in 36 (40%) SAI and were isolated with another organism in 5 episodes. Risk of SAI or death ≤14 days after surgery was greater after gastrointestinal compared with central nervous system procedures (16% vs 7%, adjusted relative risk [95% CI]: 1.95 [1.15-3.29], P = .01). Death ≤14 days after surgery occurred in 141 of the 1154 infants; 128 deaths occurred after gastrointestinal surgeries.
Conclusions |
Surgical procedures were associated with bacteremia, fungemia, or meningitis in 7% of infants. The epidemiology of invasive postoperative infections as described in this report may inform the selection of empiric antimicrobial therapy and postoperative preventive care.
Le texte complet de cet article est disponible en PDF.Keywords : neonate, premature, infection, surgery, post-operative
Abbreviations : aRR, BW, CNS, CoNS, CSF, GI, LP, NEC, NRN, PDA, ROP, SAI, SGA, SIP, SSI
Plan
| The National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (UG1 HD27904, UG1 HD21364, UG1 HD68284, UG1 HD27853, UG1 HD40492, UG1 HD27851, UG1 HD27856, UG1 HD68278, UG1 HD36790, UG1 HD27880, UG1 HD34216, UG1 HD68270, UG1 HD53109, UG1 HD53089, UG1 HD68244, UG1 HD68263, UG1 HD40689, UG1 HD21385, UG1 HD87229), and the National Center for Advancing Translational Sciences (UL1 TR1425, UL1 TR1117, UL1 TR454, UL1 TR1108, UL1 TR1085, UL1 TR442, UL1 TR1449, UL1 TR42) provided grant support for the Neonatal Research Network centers to collect and manage the data used in the study. The content of the manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors declare no conflicts of interest. |
|
| Portions of this study were presented at the Pediatric Academic Societies annual meeting, April 30-May 3, 2016, Baltimore, Maryland. |
Vol 240
P. 58 - janvier 2022 Retour au numéro
Article précédent
- Neurodevelopmental Trajectories of Preterm Born Survivors of Twin–Twin Transfusion Syndrome: From Birth to 5 Years of Age
- Patricia J.C. Knijnenburg, Marjolijn S. Spruijt, Lisette Jansen, Monique Rijken, Ratna N.G.B. Tan, Femke Slaghekke, Johanna M. Middeldorp, Enrico Lopriore, Jeanine M.M. van Klink
- 50 Years Ago in The Journal of Pediatrics : Aspirin: The Medicine That Would Not Die
- Julio C. Ramirez, Christopher Hugge
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?