Program Schedule

Infectious Complications of Pediatric Ambulatory Surgery

Session: Poster Abstract Session: Surgical Site Infections
Friday, October 10, 2014
Room: The Pennsylvania Convention Center: IDExpo Hall BC
Background: In the U.S., more than 75% of all surgical procedures are performed at an ambulatory surgical center (ASC).  Little is known about the risk of infection after pediatric ambulatory surgery.

Methods: We conducted structured parental interviews 30 to 45 days after ambulatory surgery at a children’s hospital or 3 affiliated ASC over a 13-month period. Parenteral report of a surgical site infection (SSI), antibiotic prescription with abnormal wound or wound culture triggered chart review by an Infection Preventionist.  Cases were categorized as National Healthcare Surveillance Network SSI (NHSN-SSI), a suspected SSI (for cases had 2 or more elements consistent with an SSI but failed to meet an NHSN definition), or NHSN infection at a secondary site related to surgery. 

Results: We conducted 4513 parental interviews after 6280 targeted surgeries (71.9%), including 732 hernia repairs, 549 lesion excisions, and 757 orthopedic procedures.  A total of 74 procedures (1.6%) underwent IP investigation.  Nine NHSN-SSI were identified (overall SSI rate 0.2%), including 5 after orthopedic (orthopedic SSI rate 0.7%) and 2 after urologic procedures (urologic SSI rate 0.3%).  Investigation also identified 46 suspected SSI and 1 infection at a secondary site for a possible post-operative infection rate of 1.2%. 

Conclusion: The overall rate of infectious complications after pediatric ambulatory surgery may be higher than previously appreciated although relatively few cases meet the NHSN definition for SSI.

Rachael Ross, MPH1, Jeffrey S. Gerber, MD, PhD2, Susan Rettig, BSN, CIC3, Robert Grundmeier, MD4, Heather Brouwer, B.S.1, Christina Irace, B.S.1, Russell Localio, PhD5 and Susan E. Coffin, MD, MPH6,7, (1)The Children's Hospital of Philadelphia, Philadelphia, PA, (2)Department of Pediatrics, Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA, (3)Infection Prevention and Control, The Children's Hospital of Philadelphia, Philadelphia, PA, (4)General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, (5)University of Pennsylvania, Philadelphia, PA, (6)Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA, (7)Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, PA


R. Ross, None

J. S. Gerber, None

S. Rettig, None

R. Grundmeier, None

H. Brouwer, None

C. Irace, None

R. Localio, None

S. E. Coffin, None

Findings in the abstracts are embargoed until 12:01 a.m. EDT, Oct. 8th with the exception of research findings presented at the IDWeek press conferences.

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