March 29, 2019Frontiers in PediatricsOpen Access

Risk Factors for Surgical Site Infection in Neonates: A Systematic Review of the Literature and Meta-Analysis

View Full Paper

Ask AI

Bookmark

Why the study?

Surgical site infections contribute to postoperative morbidity and mortality in children, motivating an evaluation of prevalence and risk factors specifically in neonates.

What are the risk factors for surgical site infection in neonates undergoing cervical, thoracic, or abdominal surgery?

Structured PICO

What are the risk factors for surgical site infection in neonates undergoing cervical, thoracic, or abdominal surgery?

Population

27,760 neonates and/or patients admitted to neonatal intensive care unit following cervical/thoracic/abdominal surgery from 48 studies (16,442 neonates in 10 comparative studies for meta-analysis).

Intervention

Presence of potential risk factors (gestational age, birth weight, age at surgery, length of surgical procedure, number of procedures, length of preoperative hospital stay, preoperative sepsis, preoperative antibiotic use)

Comparator

Absence of these risk factors

Outcome

Development of surgical site infection (SSI)safety

Younger neonates and those undergoing abdominal procedures are at higher risk for surgical site infections, highlighting the need for targeted preventive strategies in this vulnerable population.

Limitations

lack of evidence-based literature

Implication

Identifies neonatal SSI risk factors; supports targeted prevention protocols while leaving prospective validation open.

Abstract

Purpose: Surgical site infections (SSI) contribute to postoperative morbidity and mortality in children. Our aim was to evaluate the prevalence and identify risk factors for SSI in neonates. Methods: Using a defined strategy, three investigators searched articles on neonatal SSI published since 2000. Studies on neonates and/or patients admitted to neonatal intensive care unit following cervical/thoracic/abdominal surgery were included. Risk factors were identified from comparative studies. Meta-analysis was conducted according to PRISMA guidelines using RevMan 5.3. Data are (mean±SD) prevalence. Results: Systematic review - of 885 abstracts screened, 48 studies (27,760 neonates) were included. The incidence of SSI was 5.6% (1,564 patients). SSI was more frequent in males (61.8%), premature babies (77.4%), and following gastrointestinal surgery (95.4%). Meta-analysis - ten comparative studies (16,442 neonates; 946 SSI 5.7%) showed that predictive factors for SSI development were gestational age, birth weight, age at surgery, length of surgical procedure, number of procedure per patient, length of preoperative hospital stay, and preoperative sepsis. Conversely, preoperative antibiotic use was not significantly associated with development of SSI. Conclusions: Younger neonates and those undergoing abdominal procedures are at higher risk for SSI. Given the lack of evidence-based literature, prospective studies may help determine the risk factors for SSI in neonates.