Postoperative sepsis in infants below 6 months of age.
BACKGROUND
Sepsis is a threatening postoperative complication especially in small infants. Regarding the advances in perinatal medicine, its incidence is unknown to date. We aimed to investigate the incidence, risk factors, laboratory findings and outcome of postoperative sepsis in infants younger than 6 months old.


METHODS
We examined postoperative sepsis in babies below 6 months of age during a 4-year period at a tertiary pediatric institution.


RESULTS
The rate of postoperative sepsis was 6.9%. Laparotomy with enterotomy, thoracotomy and diaphragmatic hernia repair (P<0.05, respectively) as well as low postnatal age and long operation time (P<0.001, respectively) were correlated with the incidence of sepsis. Significant independent predictors for the development of sepsis were the presence of a central venous catheter and perioperative antibiotic treatment (P<0.001, respectively). Coagulase negative Staphylococci were the major infecting organism associated with postoperative sepsis, accounting for 53% of monomicrobial infections. Complete blood counts with differential were not different between infants with sepsis and controls, who had undergone the same surgical procedures. Outcome was favorable in all cases; however, the length of hospital stay was significantly longer in sepsis patients (P<0.05).


CONCLUSIONS
Postoperative sepsis syndrome is a frequent complication in infants below 6 months of age and causes significant prolongation of hospital stay. Adequate prevention and therapeutic strategies warrant further prospective investigations.
Kessler
Ulf
U
Department of Surgical Pediatrics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland. ulfkessler@web.de
Ebneter
Marc
M
Zachariou
Zacharias
Z
Berger
Steffen
S
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D001424:Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D002405:Catheterization, Central Venous / Q000009:adverse effects; D004766:Enterostomy / Q000009:adverse effects; D006548:Hernia, Diaphragmatic / Q000150:complications / Q000601:surgery; D006776:Hospitals, Pediatric; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D007813:Laparotomy / Q000009:adverse effects; D007902:Length of Stay; D011183:Postoperative Complications / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis; D013557:Switzerland / Q000453:epidemiology; D013908:Thoracotomy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents