Risk factors for surgical site infections after pediatric cardiovascular surgery
Risk factors for surgical site infections after pediatric cardiovascular surgery
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DOI：
10.1097/01.inf.0000114904.21616.ba
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发表时间：
2004-03-01
影响因子：
3.6
通讯作者：
Zerr, DM
中科院分区：
文献类型：
--
作者：
Allpress, AL;Rosenthal, GL;Zerr, DM
背景。尽管心血管（CV）手术后手术部位感染（SSI）的危险因素在成人中已有充分记录，但在儿童中进行的研究却很少。我们进行了一项病例对照研究，以确定接受 CV 手术的儿童住院 SSI 的危险因素。方法。前瞻性地使用国家医院感染监测系统标准来识别接受 CV 手术的患者中的住院 SSI 病例。随机选择 79 例接受 CV 手术但未住院 SSI 的患者作为对照。将病例与对照进行比较，以确定住院 SSI 的术前、术中和术后危险因素。进行多变量逻辑回归。结果。研究期间，826 名接受 CV 手术的患者中有 19 名出现 SSI（每 100 例手术 2.3 例）。 12 例感染仅限于软组织，7 例发生较深的感染。病原体包括金黄色葡萄球菌 (11 例)、凝固酶阴性葡萄球菌 (5 例) 和大肠杆菌 (2 例)。一名患者未分离出病原体。在多变量分析中，手术持续时间（比值比，1.4；95% 置信区间，1.2 至 1.8）和年龄 < 1 个月（比值比，14；95% 置信区间，3.3 至 58.4）与 SSI 独立相关。结论。年龄 < 1 个月和手术持续时间较长与儿童 CV 手术后住院 SSI 独立相关。
Background. Although risk factors for surgical site infection (SSI) after cardiovascular (CV) surgery have been well-documented among adults, few studies have been conducted in children. We performed a case-control study to identify risk factors for hospitalized SSI in children undergoing CV surgery.Methods. National Nosocomial Infections Surveillance System criteria were used prospectively to identify cases of hospitalized SSI in patients who underwent CV surgery. Seventy-nine patients who underwent CV surgery without hospitalized SSI were randomly selected as controls. Cases were compared with controls to determine preoperative, intraoperative and postoperative risk factors for hospitalized SSI. Multivariable logistic regression was performed.Results. An SSI developed in 19 of the 826 patients who underwent CV surgery (2.3 cases per 100 surgeries) during the study period. Infection was limited to soft tissue in 12, whereas deeper infection occurred in 7. Causative agents included Staphylococcus aureus (11), coagulase-negative Staphylococcus (5) and Escherichia coli (2). One patient did not have a pathogen isolated. In a multivariable analysis, duration of surgery (odds ratio, 1.4; 95% confidence interval, 1.2 to 1.8) and age < 1 month (odds ratio, 14; 95% confidence interval, 3.3 to 58.4) were independently associated with SSI.Conclusions. Age < 1 month and longer duration of surgery were independently associated with hospitalized SSI after CV surgery in children.