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Published on: February 9, 2011
Staphylococcus aureus infections after elective pediatric surgeries
Iona M Munjal1, Jill Dreyfus2, Holly Yu1
1Pfizer, Pearl River, New York.
Insights
Pediatric patients undergoing elective surgery face a risk of Staphylococcus aureus infections, especially younger children. Continued infection prevention and surveillance are crucial post-surgery.
Area of Science:
- Infectious Disease Epidemiology
- Pediatric Surgery Outcomes
- Healthcare-Associated Infections
Background:
- Postoperative infections pose a significant risk in pediatric surgery.
- Staphylococcus aureus is a common pathogen causing healthcare-associated infections.
Purpose of the Study:
- To determine the 180-day cumulative incidence of Staphylococcus aureus infections following elective pediatric surgeries.
- To analyze infection rates based on patient age and surgical setting (inpatient vs. outpatient).
Main Methods:
- Retrospective cohort study using the Premier Healthcare database (PHD).
- Included pediatric patients (<18 years) undergoing elective surgeries between 2010 and 2015.
- Defined Staphylococcus aureus infections (bloodstream, surgical site, other) using microbiology and diagnosis codes.
Main Results:
- Overall 180-day incidence of Staphylococcus aureus infections was 1.79% for inpatient and 0.36% for outpatient surgeries.
- Younger children (<2 years) had higher infection rates in both settings.
- Methicillin-resistant Staphylococcus aureus (MRSA) incidence was significantly higher after inpatient surgeries.
Conclusions:
- Postoperative Staphylococcus aureus infections represent a considerable burden in pediatric patients, particularly in younger children.
- Findings highlight the need for enhanced infection prevention strategies and extended surveillance.
- Age and surgical setting are critical factors influencing infection risk.
Objective:
To determine the 180-day cumulative incidence of culture-confirmed Staphylococcus aureus infections after elective pediatric surgeries.
Design:
Retrospective cohort study utilizing the Premier Healthcare database (PHD).
Setting:
Inpatient and hospital-based outpatient elective surgical discharges.
Patients:
Pediatric patients <18 years who underwent surgery during elective admissions between July 1, 2010, and June 30, 2015, at any of 181 PHD hospitals reporting microbiology results.
Methods:
In total, 74 surgical categories were defined using ICD-9-CM and CPT procedure codes. Microbiology results and ICD-9-CM diagnosis codes defined S. aureus infection types: bloodstream infection (BSI), surgical site infection (SSI), and other types (urinary tract, respiratory, and all other). Cumulative postsurgical infection incidence was calculated as the number of infections divided by the number of discharges with qualifying elective surgeries.
Results:
Among 11,874 inpatient surgical discharges, 180-day S. aureus infection incidence was 1.79% overall (1.00% SSI, 0.35% BSI, 0.45% other). Incidence was highest among children <2 years of age (2.76%) and lowest for those 10-17 years (1.49%). Among 50,698 outpatient surgical discharges, incidence was 0.36% overall (0.23% SSI, 0.05% BSI, 0.08% others); it was highest among children <2 years of age (0.57%) and lowest for those aged 10-17 years (0.30%). MRSA incidence was significantly higher after inpatient surgeries (0.68%) than after outpatient surgeries (0.14%; P < .0001). Overall, the median days to S. aureus infection was longer after outpatient surgery than after inpatient surgery (39 vs. 31 days; P = .0116).
Conclusions:
These findings illustrate the burden of postoperative S. aureus infections in the pediatric population, particularly among young children. These results underscore the need for continued infection prevention efforts and longer-term surveillance after surgery.
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