Nosocomial Infections Affecting Newborns with Abdominal Wall Defects

Area of Science:

• Medical research
• Pediatric surgery
• Infectious disease epidemiology

Background:

• Abdominal wall defects (AWDs) like omphalocele and gastroschisis are serious congenital malformations.
• These conditions often require prolonged hospitalization and significant healthcare resources.
• Nosocomial infections (NI) pose an additional risk, potentially worsening outcomes for affected newborns.

Purpose of the Study:

• To identify and analyze factors contributing to the occurrence of NI in neonates with AWDs.
• To evaluate trends in NI rates over a 32-year period.
• To inform strategies for reducing NI in this vulnerable patient population.

Main Methods:

• Retrospective study conducted over 32 years (1990-2021) at a tertiary children's hospital.
• Included 302 neonates diagnosed with omphalocele or gastroschisis.
• Utilized logistic regression to identify risk factors for NI.

Main Results:

• Overall NI rate was 33.7%, with common pathogens including Enterobacteriaceae, Pseudomonas aeruginosa, and Staphylococcus spp.
• A significant decrease in NI rate was observed between 2011-2021 compared to 1990-2010 (p=0.04).
• For gastroschisis, increased risk of NI was associated with anemia (OR 4.56), acute renal failure (OR 2.17), and prolonged hospitalization (>14 days). For omphalocele, NI risk increased with blood group O (OR 3.8) and anemia (OR 2.5).

Conclusions:

• Despite improvements in AWD outcomes, NI remains a critical concern.
• Specific factors such as anemia, prolonged hospitalization, and blood group O (in omphalocele cases) require targeted interventions.
• Continued vigilance and focused attention on identified risk factors are essential for optimizing care for neonates with abdominal wall defects.