Postoperative S. aureus still prevalent among children

The risk for postoperative Staphylococcus aureus infection among children who undergo surgery remains high, according to a study published in Infection Control & Hospital Epidemiology.

The authors of the collaborative, real-world study noted that S. aureus is the second most common cause of health care-associated infections among adults and children and the leading cause of health care-associated surgical site infections and ventilator-associated pneumonia. It is the second leading cause of pediatric central-line-associated bloodstream infections.

“National-level estimates of pediatric postoperative S. aureus infections based on real-world microbiological data are lacking,” the researchers wrote. “Surgeries planned during an elective admission may provide an opportunity to maximize perioperative preventive measures to decrease postoperative infections (eg, through a potential vaccine).”

They conducted their study over a 5-year period ending on June 30, 2015, at 181 U.S. hospitals from diverse geographic locations.

Among 62,572 inpatient and outpatient pediatric surgical discharges, there were 393 cases of S. aureus infection (0.63%) within 180 days of discharge. There were approximately two infections out of every 100 inpatient surgeries and 1 out of every 250 outpatient procedures.

“The infection risk was high,” the researchers wrote.

“Children with postsurgical S. aureus infections tended to be younger, had a greater frequency of Medicaid as the primary payer, and more often had their surgery at a teaching hospital,” they wrote. “Children with vs. without S. aureus infection after inpatient surgery were less often discharged to home, were more frequently discharged to another facility, and were more often given codes for complex chronic conditions, indicating a higher level of medical complexity.”

The incidence of S. aureus was highest among children aged 2 years or younger following both inpatient and outpatient surgical discharges.

“The surgeries and patient characteristics with higher incidence of infections represent priority areas for existing and novel methods for prevention, such as vaccination. These results may help guide targeted postsurgery infection prevention efforts among children after surgeries performed at U.S. hospitals,” the researchers wrote.