title: Surgical site infections in a longitudinal cohort of neonatal intensive care unit patients.
abstract: OBJECTIVE
  To estimate the incidence and identify risk factors for surgical site infections (SSIs) among infants in the neonatal intensive care unit (NICU).
  
  
  METHODS
  A prospective cohort study of infants undergoing surgical procedures from May 2009 to April 2012 in three NICUs was performed. SSI was identified if documented by an attending neonatologist and treated with intravenous antibiotics. Independent risk factors were identified using logistic regression, adjusting for NICU.
  
  
  RESULTS
  A total of 902 infants underwent 1346 procedures and experienced 60 SSIs (incidence: 4.46/100 surgeries). Risk factors for SSIs included younger chronological age (odds ratio (OR) 1.03 per day decrease, 95% confidence interval (CI) 1.01, 1.04), lower gestational age (OR 1.09 per week decrease, CI 1.02, 1.18), male sex (OR 1.17, CI 1.04, 1.34) and use of central venous catheter (OR 4.40, CI 1.19, 9.62). Only 43% had surgical site cultures obtained and Staphylococcus aureus was most commonly isolated.
  
  
  CONCLUSIONS
  SSIs complicated 4.46% of procedures performed in the NICU. Although few modifiable risk factors for SSIs were identified, future efforts should focus on evaluating the impact of current prevention strategies on the incidence of neonatal SSI.
authors.affiliation: Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Prasad
authors.affiliation: School of Nursing, Columbia University Medical Center, New York, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Wong-McLoughlin
authors.affiliation: Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Patel
authors.affiliation: Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Infection Prevention and Control, Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Coffin
authors.affiliation: Division of Infectious Diseases, Children's Hospital of Philadelphia, Philadelphia, PA, USA.|Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: T E
authors.initials: TE
authors.lastname: Zaoutis
authors.affiliation: Department of Pediatrics, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: J
authors.initials: J
authors.lastname: Perlman
authors.affiliation: Department of Pediatrics, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: P
authors.initials: P
authors.lastname: DeLaMora
authors.affiliation: Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.
authors.forename: L
authors.initials: L
authors.lastname: Alba
authors.affiliation: School of Nursing, Columbia University Medical Center, New York, NY, USA.
authors.forename: Y-h
authors.initials: YH
authors.lastname: Ferng
authors.affiliation: Department of Pediatrics, Columbia University Medical Center, New York, NY, USA.|Department of Infection Prevention and Control, New York-Presbyterian Hospital, New York, NY, USA.
authors.forename: L
authors.initials: L
authors.lastname: Saiman
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology*; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002437:Cefazolin