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S. aureus causes most SSI in pediatric spine surgery patients
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Surgical site infections in pediatric patients who underwent spine surgery were most likely to be caused by Staphyloccocus aureus, gram-negative bacilli and gram positive anaerobe cocci, according to a recent study.
“In pediatric spine surgery, S. aureus was the most frequent bacteria in both idiopathic and nonidiopathic cases, most often found as single pathogen,” Matthieu Maesani, MD, MSc, of the department of anesthesiology and intensive care at the Robert-Debré Hospital, Paris, and colleagues wrote. “In contrast, gram-negative bacilli was the second most frequent pathogen in nonidiopathic cases and often found in polymicrobial cultures.”
The researchers analyzed patients who underwent 496 spine procedures conducted at a pediatric hospital in France from 2007 through 2011. Surgical site infections (SSI) were categorized by whether there was an abscess in the deep surgical site, whether there were signs of infection such as fever or swelling and whether there was a positive bacterial culture extracted from the surgical site. Epidemiological, surgical, and anesthetic management data were gathered from all but six patients.
Study results showed that SSI were identified in 51 patients, with S. aureus found in 61% of SSI, regardless of etiology.
Subsequent secondary pathogen dominance differed based on the etiology of a patient’s spine deformity. The second most frequent pathogens detected were gram-negative bacilli (Pseudomonas aeruginosa) found in nonidiopathic patients and gram-positive anaerobe cocci in idiopathic patients. Nonidiopathic patients had an infection rate of 15.9% compared with 6.8% among idiopathic patients with spine disease.
“Our study emphasizes the need for appropriate intraoperative preventive anti-gram–negative bacilli antibiotics in nonidiopathic patients, as a high proportion of gram-negative bacilli was resistant to cefamandole and cefazolin which are recommended as antibiotic prophylaxis,” Maesani and colleagues wrote. – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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