A prospective study of surgical site infections in a pediatric hospital in Mexico City

Background: Pediatric surgical site infection (SSI) rates in the United States range from 2.5% to 4.4%. There is little data regarding their risk factors among children. We quantified SSI rates and identified risk factors of SSI in a tertiary care pediatric teaching hospital in Mexico City. Methods: All neurosurgical, cardiovascular, and general surgical patients who underwent operation between Aug 1, 1998, and Jan 31, 1999, were followed-up daily during hospitalization. On postoperative day 30, a full review of microbiology reports and medical records was performed. Univariate and multivariate analyses were done to identify risk factors. Results: Four hundred twenty-eight of 530 children completed follow-up. The overall SSI rate was 18.7%. Forty percent of SSI were superficial incisional, 21 % were deep incisional, and 39% were organ/space infections. For clean, clean-contaminated, contaminated, and dirty procedures, SSI infection rates were 12.4 %, 24.4 %, 14.3 %, and 32.4 %, respectively. Open drains (OR = 2.3; 95 % CI = 1.34.2; P < .005) and surgery that lasted 90 or more minutes (OR = 2.9; 95% CI = 1.6-5.1; P < .001) were associated with infection. Conclusions: Our rates are greater than comparable reported data among children. Duration of surgery and use of open drains were associated with SSI.