The Role of Anesthetic Management in Surgical Site Infections After Pediatric Intestinal Surgery

Shibamura‐Fujiogi, Miho; Ormsby, Jennifer; Breibart, Mark; Zalieckas, Jill M.; Sandora, Thomas J.; Priebe, Gregory P.; Yuki, Koichi

doi:10.1016/j.jss.2020.10.015

Cited by 8 publications

(10 citation statements)

References 38 publications

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“…In our previous work using a preclinical model, a long exposure (6-hour) of volatile anesthetics was associated with increased infection, while a short exposure (2-hour) was not [42]. In a study at our institution, we previously showed that higher volatile anesthetic dose was an independent risk factor for SSI in pediatric gastrointestinal surgery [43]. Anesthetic drugs and oxygen dosage also had no impact on the incidence of SSIs.…”

Section: Trichosporon Asahii 1 Csf Cerebrospinal Uid Discussionmentioning

confidence: 94%

Risk Factors for Pediatric Surgical Site Infection Following Neurosurgical Procedures for Hydrocephalus: A Retrospective Single-Center Cohort Study

Shibamura‐Fujiogi

Ormsby

Breibart

et al. 2021

Preprint

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Background Infection is a major complication following cerebral spinal fluid (CSF) diversion procedures for hydrocephalus. However, their pediatric risk factors for surgical site infection (SSI) are currently not well defined. Because SSI prevention bundle is increasingly introduced, the purpose of this study was to evaluate risk factors associated with SSIs following CSF diversion surgeries under SSI bundle at a single quaternary care pediatric hospital.Methods We performed a retrospective cohort study of patients undergoing CSF diversion procedures from 2017 to 2019. SSIs were identified prospectively through continuous surveillance. We performed univariate analyses to determine an association between SSIs and patient demographics, comorbidities and perioperative factors, with subsequent multivariate logistic regression analyses to identify independent risk factors for SSI.Results We identified a total of 561 CSF diversion procedures with an overall SSI rate of 3.6%. In univariate analyses, older age, number of previous shunt revisions and comorbid cardiac disease were significantly associated with SSI. In multivariate analyses, history of brain tumor (OR2.75, 95%CI 1.03-7.33, P=0.04) and cardiac comorbidities (OR9.47, 95%CI 2.15-41.73, P=0.003) were significantly associated with SSIs. When endoscopic third ventriculostomy was excluded, only cardiac disease was independently associated with SSI. Cardiac diseases associated with SSI included single ventricle disease with palliative repair and valvulopathy with underlying connective tissue diseases. Conclusion This study showed that comorbid conditions (cardiac disease, brain tumor) were more important than perioperative factors as risk factors for SSI in pediatric patients undergoing CSF diversion procedures. Further investigation is needed to define the mechanisms behind these associations.

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Section: Trichosporon Asahii 1 Csf Cerebrospinal Uid Discussionmentioning

confidence: 94%

Risk Factors for Pediatric Surgical Site Infection Following Neurosurgical Procedures for Hydrocephalus: A Retrospective Single-Center Cohort Study

Shibamura‐Fujiogi

Ormsby

Breibart

et al. 2021

Preprint

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“…The most frequently detected pathogens detected in pediatric and neonatal SSIs are shown in Table 3 [22,27,29,32,33,[38][39][40][41]43]. 1 Some patients had cultures positive for more than one bacteria species.…”

Section: Etiology Of Ssis In Children and Neonatesmentioning

confidence: 99%

“…Regarding gastrointestinal paediatric surgery, Shibamura-Fujiogi et al studied a single center paediatric population of children who had undergone elective intestinal surgery at the Boston Children’s Hospital; among 621 enrolled patients, 39 met the criteria for SSIs [ 29 ]. This study focused specifically on the role that anaesthetics could play in the development of SSIs, reporting that the SSI rates were higher in children who had been administered a higher dose of anaesthetics (isoflurane and levoflurane) [ 29 ].…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

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Prevention of Surgical Site Infections in Neonates and Children: Non-Pharmacological Measures of Prevention

et al. 2022

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A surgical site infection (SSI) is an infection that occurs in the incision created by an invasive surgical procedure. Although most infections are treatable with antibiotics, SSIs remain a significant cause of morbidity and mortality after surgery and have a significant economic impact on health systems. Preventive measures are essential to decrease the incidence of SSIs and antibiotic abuse, but data in the literature regarding risk factors for SSIs in the pediatric age group are scarce, and current guidelines for the prevention of the risk of developing SSIs are mainly focused on the adult population. This document describes the current knowledge on risk factors for SSIs in neonates and children undergoing surgery and has the purpose of providing guidance to health care professionals for the prevention of SSIs in this population. Our aim is to consider the possible non-pharmacological measures that can be adopted to prevent SSIs. To our knowledge, this is the first study to provide recommendations based on a careful review of the available scientific evidence for the non-pharmacological prevention of SSIs in neonates and children. The specific scenarios developed are intended to guide the healthcare professional in practice to ensure standardized management of the neonatal and pediatric patients, decrease the incidence of SSIs and reduce antibiotic abuse.

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“…The low number of patients assigned to each arm following matching might have significantly affected the result in this study. We also examined the risk factors of SSIs in 621 pediatric patients (average age of 8.8 years) undergoing gastrointestinal surgery from 2017 to 2019 [100]. These surgeries were performed under our institutional SSI bundle, and SSIs were prospectively examined.…”

Section: Clinical Studies Regarding Anesthetic Drugs and Surgicalmentioning

confidence: 99%

Surgical Site Infections and Perioperative Optimization of Host Immunity by Selection of Anesthetics

Yuki

Shibamura‐Fujiogi

2021

BioMed Research International

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Surgical site infections are significant health care issues, and efforts to mitigate their occurrence have been ongoing worldwide, mainly focusing to reduce the spillage of microbes to the otherwise sterile tissues. Optimization of host immunity has been also recognized including temperature regulation (normothermia), adequate oxygenation, and glucose management. A number of papers have described the role of anesthetics in host immunity. The role of anesthetics in postoperative outcomes including surgical site infections has been also studied. We will review the current literature and propose the importance of anesthetic selection to potentially mitigate surgical site infections.

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The Role of Anesthetic Management in Surgical Site Infections After Pediatric Intestinal Surgery

Cited by 8 publications

References 38 publications

Risk Factors for Pediatric Surgical Site Infection Following Neurosurgical Procedures for Hydrocephalus: A Retrospective Single-Center Cohort Study

Risk Factors for Pediatric Surgical Site Infection Following Neurosurgical Procedures for Hydrocephalus: A Retrospective Single-Center Cohort Study

Prevention of Surgical Site Infections in Neonates and Children: Non-Pharmacological Measures of Prevention

Surgical Site Infections and Perioperative Optimization of Host Immunity by Selection of Anesthetics

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