Cargando…
Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study
INTRODUCTION: Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in chil...
Formato: | Online Artículo Texto |
---|---|
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716674/ https://www.ncbi.nlm.nih.gov/pubmed/33272940 http://dx.doi.org/10.1136/bmjgh-2020-003429 |
_version_ | 1783619209923657728 |
---|---|
collection | PubMed |
description | INTRODUCTION: Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. METHODS: A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). RESULTS: Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. CONCLUSION: The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda. |
format | Online Article Text |
id | pubmed-7716674 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-77166742020-12-11 Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study BMJ Glob Health Original Research INTRODUCTION: Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. METHODS: A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). RESULTS: Of 1159 children across 181 hospitals in 51 countries, 523 (45·1%) children were from high HDI, 397 (34·2%) from middle HDI and 239 (20·6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12·8% (51/397) in middle HDI and 24·7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. CONCLUSION: The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda. BMJ Publishing Group 2020-12-03 /pmc/articles/PMC7716674/ /pubmed/33272940 http://dx.doi.org/10.1136/bmjgh-2020-003429 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Research Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study |
title | Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study |
title_full | Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study |
title_fullStr | Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study |
title_full_unstemmed | Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study |
title_short | Surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study |
title_sort | surgical site infection after gastrointestinal surgery in children: an international, multicentre, prospective cohort study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716674/ https://www.ncbi.nlm.nih.gov/pubmed/33272940 http://dx.doi.org/10.1136/bmjgh-2020-003429 |
work_keys_str_mv | AT surgicalsiteinfectionaftergastrointestinalsurgeryinchildrenaninternationalmulticentreprospectivecohortstudy |