Surgical Site Infections in a Longitudinal Cohort of Neonatal Intensive Care Unit Patients

OBJECTIVE: To estimate the incidence and identify risk factors for surgical site infections (SSIs) among infants in the neonatal ICU (NICU). STUDY DESIGN: A prospective cohort study of infants undergoing surgical procedures May 2009–April 2012 in three NICUs was performed. SSI was identified if documented by an attending neonatologist and treated with intravenous (IV) antibiotics. Independent risk factors were identified using logistic regression, adjusting for NICU. RESULT: A total of 902 infants underwent 1,346 procedures and experienced 60 SSIs (incidence: 4.46/100 surgeries). Risk factors for SSIs included younger chronologic age(OR 1.03/day decrease,95% CI 1.01,1.04), lower gestational age(OR 1.09/week decrease, CI 1.02,1.18), male sex(OR 1.18, CI1.04,1.34), and use of central venous catheter(OR 4.40, CI1.89,10.24). Only 43% had surgical site cultures obtained and Staphylococcus aureus was most commonly isolated. CONCLUSION: SSIs complicated 4.46% of procedures performed in the NICU. Although few modifiable risk factors for SSIs were identified, future efforts should focus on evaluating the impact of current prevention strategies on the incidence of neonatal SSI.