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Surgery-Associated Infections among Infants Born Extremely Preterm
Andi L Shane1, Nellie I Hansen2, Mohannad Moallem3
1Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA.
Surgery-associated infections (SAI) occurred in 7% of extremely premature infants. Gastrointestinal surgeries posed a higher risk for these invasive infections and death compared to central nervous system procedures.
Area of Science:
- Neonatalogy
- Infectious Diseases
- Surgical Outcomes
Background:
- Surgery is common in extremely premature infants.
- Understanding the risks of surgery-associated infections (SAI) is crucial for this vulnerable population.
Purpose of the Study:
- To determine the incidence and characteristics of invasive infections following surgical procedures in extremely premature infants.
Main Methods:
- Prospective observational study of infants born between 22-28 weeks gestation.
- SAI defined as culture-confirmed bacteremia, fungemia, or meningitis within 14 days of surgery.
- Data collected from April 2011 to March 2015 across Neonatal Research Network centers.
Main Results:
- 18% of 6573 infants underwent surgery; 7% developed SAI.
- Gastrointestinal procedures (76%) were most common.
- Coagulase-negative staphylococci were the most frequent pathogen (40%).
- Risk of SAI or death was higher after gastrointestinal surgery (16%) versus CNS surgery (7%).
Conclusions:
- Invasive postoperative infections affect 7% of extremely premature infants undergoing surgery.
- Findings can guide empiric antimicrobial therapy and preventive strategies for postoperative care.
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