Incidence and Risk Factors of Surgical site Infection: a Cohort of 960 Patients …

SABBATINI, S. ; REIS, ADRIANA TEIXEIRA ; Gomes Júnior, Saint Clair ; Nogueira, Antonio Roberto Richa . Incidence and risk factors of surgical site infection: a cohort of 960 patients in a brazilian pediatric tertiary Center. Journal of Infection Control, v. 7, p. sn, 2018.

Background and objectives
To assess the incidence of surgical site infection (SSI), establish its risk factors and the importance of post discharge active surveillance in determining its real incidence.

Methods
All children operated from April/2013 to April/2015, at the Department of Pediatric Surgery of the Instituto Fernandes Figueira, in Rio de Janeiro, Brazil and followed prospectively for 30 days were included. CDC criteria were used for definition of SSI, wound classification and level of infection. Student’s t-test or chi-square test was applied for numeric variables or categorical variables, respectively. The adjusted odds ratios of SSI were estimated from the logistic model.

Results
In 960 patients who underwent 1003 operations, of whom 179 neonates with 189 surgeries, the overall SSI rate was 5.5%. A significant association for the occurrence of SSI was observed with age, wound class (clean, clean-contaminated, contaminated, dirty/infected), and patient status (inpatient or outpatient). Multivariate analisys identified an association of SSI with inpatient status
(OR=5.581;95% CI 1.677 – 18.574) and neonate (OR=2.631; 95% CI 1.430 – 4.389). Active search covered 91% of patients and identified 9% of SSI by phone interview.

Conclusion
Patient status, neonate and wound class were associated to a statistically significant higher risk of developing SSI. Active surveillance until the 30th postoperative day was important for accuracy of SSI rates.

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