title: Surgical site infection rates and risk factors in orthopedic pediatric patients in Madrid, Spain.
abstract: BACKGROUND
  The objective of the study is to study surgical site infection (SSI) rates and risk factors in a pediatric population.
  
  
  METHODS
  We conducted a prospective cohort study to estimate the SSI rate at a national pediatric referral center, covering all patients managed at the Orthopedic Surgery Department of the Niño Jesús Children's University Teaching Hospital from January 2010 through December 2012. Risk factors and antibiotic prophylaxis were monitored. A comparison between Spanish and US data was performed, with a breakdown by National Nosocomial Infection Surveillance risk indices. We also conducted a comparative study of SSI rates from 2010 to 2012 to assess the impact of the epidemiologic surveillance system.
  
  
  RESULTS
  The study population of 1079 patients had a SSI rate of 2.8%. SSI rates were calculated for spinal fusion and other musculoskeletal procedures according to the National Nosocomial Infection Surveillance risk index. In the case of other musculoskeletal procedures, our SSI rates were 0.8 times lower than the overall Spanish rate, but higher than US rates for all risk categories. For spinal fusion procedures, our SSI rates were 1.2 times higher than the Spanish rates and 3.5 times higher than National Nosocomial Infection Surveillance rates. This latter finding should be interpreted with caution because it was based on a small sample. The multivariate analysis indicated that the only predictive factors of SSI were American Society of Anesthesiologists score and age.
  
  
  CONCLUSIONS
  The surveillance program showed that for clean procedures, SSI incidence decreased from 4% in 2010 to 3.2% in 2011 and to 2.4% in 2012.
authors: From the *Department of Epidemiology and Preventive Medicine, Niño Jesús Children's University Teaching Hospital, Avda. Menéndez Pelayo, Madrid; †Department of Epidemiology and Preventive Medicine, Alcorcón Foundation University Teaching Hospital, C/Budapest, Alcorcón; and ‡Department of Orthopedics Pediatric Surgery, Niño Jesús Children's University Teaching Hospital, Avda. Menéndez Pelayo, Madrid, Spain.
authors: Almudena Quintás
authors: AQ
authors: Viqueira
authors: Gil Rodríguez
authors: GR
authors: Caravaca
authors: José Antonio
authors: JA
authors: Quesada Rubio
authors: Victoria Soler
authors: VS
authors: Francés
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D062665:Epidemiological Monitoring; D006801:Humans; D007223:Infant; D017053:Infection Control; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult