title: Infections reported in newborns with very low birth weight who required surgical treatment. Data from the Polish Neonatology Surveillance Network.
abstract: OBJECTIVE
  To determine the risk of various forms of infections appearing in very low birth weight newborns (VLBW) during the period of 30 days after surgical treatment in hospitals which have perinatal care departments with neonatal intensive care units that form the Polish Neonatology Surveillance Network (PNSN).
  
  
  METHODS
  Continuous prospective monitoring of infections was carried out from January 1st to December 31st 2009 in six neonatal intensive care units which form the Polish Neonatal Surveillance Network. (PNSN). 910 newborns with very low birth weight (VLBW) were included in the study programme. 91 (10%) of this group underwent 118 surgical interventions. 12 newborns needed two or more surgeries. The most common procedure was the closure of persistent ductus artesiosus (PDA) and photocoagulation of vascular damage in the eye fundus.
  
  
  RESULTS
  In the period of 30 days after surgery the following were diagnosed: in 3 newborns - necrotizing enterocolitis (NEC), in 22 newborns - sepsis (BSI) and in 54 newborns - pneumonia (PNEU). Symptoms of BSI and PNEU were on average observed on the 10th day after surgical intervention, while in the case of NEC on the 17th day. The highest incidence of infection (148.4%) was observed after PDA closure and in connection with introducing a drain into the pleural cavity through the intercostal space. The incidence of PN EU (37.3%) was twice as high as the incidence of BSI (18.6%). Surgical procedure was a factor significantly increasing the risk of infection and morbidity (RR 2.1, P<001) In our investigations there was no case of the local infection of a surgical site. 11 newborns died (mortality was 12.1%). The most common bacterial strains found in our investigation were coagulase-negative Staphylococcus and Escherichia Coli.
  
  
  CONCLUSIONS
  Taking into consideration the fact that surgical procedure in VLBW-newborns significantly increases the risk of pneumonia and to a minor degree the risk of NEC and BSI, further detailed investigation in the field of perisurgical epidemiology is needed in order to elaborate a more deeply oriented and more effective strategy of infection prevention in the group of VLBW newborns.
authors.affiliation: Klinika Neonatologii i Intensywnej Terapii, Warszawa. klinika.neonatologii@imid.med.pl
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Wójkowska-Mach
authors.forename: Ewa
authors.initials: E
authors.lastname: Helwich
authors.forename: Maria
authors.initials: M
authors.lastname: Borszewska-Kornacka
authors.forename: Janusz
authors.initials: J
authors.lastname: Gadzinowski
authors.forename: Ewa
authors.initials: E
authors.lastname: Gulczyńska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Kordek
authors.forename: Dorota
authors.initials: D
authors.lastname: Pawlik
authors.forename: Jerzy
authors.initials: J
authors.lastname: Szczapa
authors.forename: Joanna
authors.initials: J
authors.lastname: Domańska
authors.forename: Jerzy
authors.initials: J
authors.lastname: Klamka
authors.forename: Piotr B
authors.initials: PB
authors.lastname: Heczko
mesh_terms: D004927:Escherichia coli Infections / Q000175:diagnosis / Q000453:epidemiology*; D005123:Eye; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000601:surgery*; D019102:Infant, Very Low Birth Weight; D017053:Infection Control / Q000379:methods*; D008028:Light Coagulation; D008297:Male; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000382:microbiology; D011446:Prospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology*