Preoperative Staphylococcus aureus Carriage and Risk of Surgical Site Infection After Cardiac Surgery in Children...

Area of Science:

• Pediatric Surgery
• Infectious Diseases
• Clinical Microbiology

Background:

• Surgical site infections (SSI) are a significant concern in pediatric cardiac surgery, increasing patient morbidity and healthcare costs.
• Staphylococcus aureus (SA) carriage is a known risk factor for SSI in adults, but its role in pediatric populations is not well-established.

Purpose of the Study:

• To determine the prevalence of SA colonization in infants under one year old undergoing cardiac surgery.
• To compare the incidence of SSI and other nosocomial infections (NI) between preoperative SA carriers and non-carriers.

Main Methods:

• Prospective, monocentric cohort study involving 68 children under one year old undergoing cardiac surgery.
• Preoperative screening for methicillin-resistant (MRSA) and methicillin-sensitive SA (MSSA) using real-time PCR.
• Follow-up for one year post-surgery to monitor for SSI and other NI.

Main Results:

• The overall prevalence of SA colonization was 26.5% (23.5% MSSA, 2.9% MRSA).
• No significant difference in SSI rates was observed between colonized and non-colonized children (16.7% vs. 20%; p=0.53).
• Ventilator-associated pneumonia (VAP) rates were significantly higher in SA carriers compared to non-carriers (22.2% vs. 2%; p<0.05).

Conclusions:

• Methicillin-sensitive SA colonization is frequent in infants undergoing cardiac surgery, while MRSA prevalence is low.
• SA colonization was not associated with an increased incidence of SSI in this pediatric cohort.
• Further research is warranted to fully elucidate the association between SA colonization and infection outcomes in pediatric cardiac surgery patients.