Health Care-Associated Infections following Major Neonatal Surgery in a Resource-Limited Setting: Risk Factors and...

Area of Science:

• Neonatal Surgery
• Infectious Diseases
• Public Health

Background:

• Healthcare-associated infections (HAIs) pose a major threat to neonates undergoing surgery, particularly in resource-limited settings with suboptimal infection control.
• This study investigates risk factors for HAIs in neonatal thoracic and abdominal surgery in southern Tunisia.

Purpose of the Study:

• To identify independent risk factors associated with healthcare-associated infections (HAIs) in neonates undergoing major non-cardiac thoracic and abdominal surgery.
• To inform strategies for reducing infection rates and improving outcomes in neonatal surgical care.

Main Methods:

• A retrospective cohort study was conducted involving neonates who underwent major non-cardiac abdominal or thoracic surgery.
• Data were collected from April 2015 to March 2025 at Hedi Chaker University Hospital, Sfax, Tunisia.

Main Results:

• Of 361 neonates, 99 (27.4%) developed HAIs.
• Independent risk factors for HAIs included cardiac comorbidities (OR=2.205), gestational age <37 weeks (OR=2.448), postoperative intubation >30 hours (OR=2.338), and surgery duration >120 min (OR=2.471).
• Common surgical conditions included esophageal atresia (n=105), duodenal atresia (n=42), and anorectal malformations (n=39).

Conclusions:

• HAIs in neonatal surgery are a significant challenge, influenced by patient factors, surgical procedures, and resource limitations.
• Strengthening neonatal intensive care unit (NICU) capacity and optimizing perioperative protocols are crucial for reducing infection rates.
• Ensuring consistent access to essential medical supplies like antibiotics and antiseptics is vital for improved patient outcomes.