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Infections after pediatric ambulatory surgery: Incidence and risk factors

Jeffrey S Gerber1, Rachael K Ross1, Julia E Szymczak2

  • 11Division of Infectious Diseases and Center for Pediatric Clinical Effectiveness,Children's Hospital of Philadelphia,Philadelphia,Pennsylvania.

Infection Control and Hospital Epidemiology
|January 31, 2019
PubMed

Insights

The rate of surgical site infections (SSIs) after pediatric ambulatory surgery is low. However, standard surveillance may miss many infections, indicating a higher burden of surgical morbidity.

Area of Science:

  • Pediatric Surgery
  • Infectious Disease Epidemiology
  • Healthcare Quality Improvement

Background:

  • Surgical site infections (SSIs) are a significant concern in healthcare settings.
  • Ambulatory surgery is increasingly common for pediatric patients.
  • Understanding SSI epidemiology in pediatric ambulatory surgery is crucial for patient safety.

Purpose of the Study:

  • To describe the epidemiology of surgical site infections (SSIs) following pediatric ambulatory surgery.
  • To compare SSI rates between ambulatory surgical facilities (ASFs) and hospital-based facilities.
  • To identify factors associated with SSIs in this population.

Main Methods:

  • An observational cohort study was conducted with 8,502 pediatric patients undergoing surgery.
  • Data collection involved parental interviews and chart reviews over a 60-day follow-up period.
  • Two SSI definitions were used: National Healthcare Safety Network (NHSN)-defined SSI and a broader definition of possible infection.

Main Results:

  • The rate of NHSN-defined SSIs was 2.5 per 1,000 surgical encounters, with similar rates in ASFs and hospital-based facilities after adjustment.
  • A broader definition identified 48 possible infections per 1,000 encounters, with significant under-documentation in charts.
  • Older age and Black race were associated with a reduced risk of possible infection.

Conclusions:

  • The incidence of NHSN-defined SSIs after pediatric ambulatory surgery is low.
  • Standard surveillance methods may underestimate the true burden of infectious complications.
  • Further research is needed to refine surveillance strategies for pediatric ambulatory surgery.
Abstract

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