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Updated: Sep 23, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 10, 2011
[Infection of pediatric operative wounds in a general hospital (author's transl)]
Insights
Pediatric surgical wound infection rates were low, with "clean" wounds primarily infected by Staphylococcus. Other wound types showed higher infection rates due to endogenous flora, guiding limited antibiotic use.
Area of Science:
- Pediatric Surgery
- Infectious Disease Epidemiology
- Bacteriology
Background:
- Surgical site infections (SSIs) are a significant concern in pediatric surgery.
- Understanding infection patterns is crucial for effective prevention strategies.
Purpose of the Study:
- To determine the incidence and causative agents of postoperative surgical wound infections in pediatric patients.
- To analyze infection rates across different wound classifications.
- To inform antibiotic usage based on bacteriologic findings.
Main Methods:
- Prospective study of 1,124 pediatric surgical procedures over two years (1977-1978).
- Classification of wounds into "clean," "clean-contaminated," "contaminated," and "dirty" categories.
- Bacteriologic analysis of wound cultures to identify infecting microorganisms.
Main Results:
- Overall infection rate was 3.29% (37/1,124).
- "Clean" wounds had a low infection rate (1.18%) primarily caused by Staphylococcus.
- "Contaminated" and "dirty" wounds exhibited higher infection rates (9.37% and 20.43%) with diverse endogenous flora, including Enterobacteriaceae and anaerobes.
- No mortality was directly attributed to wound infections.
Conclusions:
- Pediatric surgical wound infection rates are comparable to adult rates.
- Bacteriologic profiles differ significantly by wound classification, supporting targeted antibiotic use.
- Reducing SSIs is important due to patient morbidity and increased healthcare costs.
Abstract:
During the two-year 1977-1978 period 37 (3.29%) out of 1,124 pediatric surgical wounds became infected in the postoperative course. Ten infections were observed among the 844 "clean" procedures (1.18%), 5/155 "clean-contaminated" (3.22%), 3/32 "contaminated" (9.37%) and 19/93 "dirty" (20.43%). These rates are quite comparable, although somewhat lower, to those found in similar studies carried out in adults. The bacteriologic studies of the contamination and the subsequent infection revealed that "clean" wounds were almost exclusively infected by "Staphilococci", while all the remaining categories (which very often implicated an opening of digestive tract lumen) became infected by multiple endogenous flora including enterobacteriae (mainly "E. coli") and anaerobic germs ("Bacteroides" and "Clostridia"). The limited use of antibiotics in this series was guided by these bacteriologic findings, a fact that can partially explain our results. There was no mortality directly related to the infection of the wound, but the risks and uncomfort incurred by the patients were not negligible and must be taken into consideration aside with the increase of the cost of hospital stay (evaluated as 35,000-100,000 ptas./patient in this series) to justify every effort to decrease incidence of this generally minor complication.
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