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Staphylococcus aureus infections after elective pediatric surgeries

Published online by Cambridge University Press:  11 March 2022

Iona M. Munjal
Affiliation:
Pfizer, Pearl River, New York
Jill Dreyfus*
Affiliation:
Premier Applied Sciences, Premier, Charlotte, North Carolina
Holly Yu
Affiliation:
Pfizer, Pearl River, New York
Elizabeth Begier
Affiliation:
Pfizer, Pearl River, New York
Alejandra Gurtman
Affiliation:
Pfizer, Pearl River, New York
Julie A. Gayle
Affiliation:
Premier Applied Sciences, Premier, Charlotte, North Carolina
Margaret A. Olsen
Affiliation:
Washington University School of Medicine, St. Louis, Missouri
*
Author for correspondence: Jill Dreyfus, E-mail: Jill.Dreyfus@pfizer.com

Abstract

Objective:

To determine the 180-day cumulative incidence of culture-confirmed Staphylococcus aureus infections after elective pediatric surgeries.

Design:

Retrospective cohort study utilizing the Premier Healthcare database (PHD).

Setting:

Inpatient and hospital-based outpatient elective surgical discharges.

Patients:

Pediatric patients <18 years who underwent surgery during elective admissions between July 1, 2010, and June 30, 2015, at any of 181 PHD hospitals reporting microbiology results.

Methods:

In total, 74 surgical categories were defined using ICD-9-CM and CPT procedure codes. Microbiology results and ICD-9-CM diagnosis codes defined S. aureus infection types: bloodstream infection (BSI), surgical site infection (SSI), and other types (urinary tract, respiratory, and all other). Cumulative postsurgical infection incidence was calculated as the number of infections divided by the number of discharges with qualifying elective surgeries.

Results:

Among 11,874 inpatient surgical discharges, 180-day S. aureus infection incidence was 1.79% overall (1.00% SSI, 0.35% BSI, 0.45% other). Incidence was highest among children <2 years of age (2.76%) and lowest for those 10–17 years (1.49%). Among 50,698 outpatient surgical discharges, incidence was 0.36% overall (0.23% SSI, 0.05% BSI, 0.08% others); it was highest among children <2 years of age (0.57%) and lowest for those aged 10–17 years (0.30%). MRSA incidence was significantly higher after inpatient surgeries (0.68%) than after outpatient surgeries (0.14%; P < .0001). Overall, the median days to S. aureus infection was longer after outpatient surgery than after inpatient surgery (39 vs. 31 days; P = .0116).

Conclusions:

These findings illustrate the burden of postoperative S. aureus infections in the pediatric population, particularly among young children. These results underscore the need for continued infection prevention efforts and longer-term surveillance after surgery.

Type
Original Article
Copyright
© Pfizer, Inc., 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION: Portions of this work were previously presented at the Pediatric Academic Societies Meeting on May 5–8, 2018, in Toronto, Canada.

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