Postoperative sepsis in infants below 6 months of age
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Postoperative sepsis in infants below 6 months of age Ulf Kessler, Marc Ebneter, Zacharias Zachariou, Steffen Berger Bern, Switzerland
Methods: We examined postoperative sepsis in babies below 6 months of age during a 4-year period at a tertiary pediatric institution. Results: The rate of postoperative sepsis was 6.9%. Laparotomy with enterotomy, thoracotomy and diaphragmatic hernia repair (P19.5 or 17.5 or 10% immature neutrophils).[7] The following parameters were recorded: birth weight (BW), gestational age (GA), gender, Apgar score, mode of delivery (caesarean-section versus vaginal delivery), perinatal complications, duration of preoperative and total hospital stay, type of surgical treatment, length of surgery, presence of a central venous catheter (CVC), perioperative antibiotic prophylaxis and growth of bacterial culture. Because of the diversity of surgical interventions, the procedures were classified as to their contamination potential (Table 1). In infants with sepsis and in the three procedure groups with the highest risk for sepsis (control group), complete blood cell counts with differential and CRP levels were recorded. In sepsis patients, we recorded laboratory parameters on the World J Pediatr, Vol 5 No 2 . May 15, 2009 . www.wjpch.com
day of initial symptoms. In addition, the laboratory parameters taken before and after initial laboratory evaluation for sepsis were recorded. Since the mean duration from operation to symptoms of sepsis was 9±5 days, the parameters in the control group were recorded on postoperative day 9±1, as well as those taken before and afterwards. Hematological parameters were evaluated using a Coulter Counter (Celldyn 3500 R, Abbott, IL, USA). Plasma CRP concentrations were quantitated by a latex photometric assay (Hitachi 917, Boehringer Mannheim, Germany). Statistical analysis was performed using SPSS© version 15. Stepwise multivariate logistic regression analysis was used to identify independent factors associated with the occurrence of postoperative sepsis. Associations between variables were determined using Pearson's product-moment correlation coefficient. Differences between the two groups were assessed using Student's t test in case of equivalent variation and normal distribution of values. Otherwise, the MannWhitney U Test was performed. Ordinal data were assessed using the Chi-square test and Fisher's exact test. Changes of laboratory parameters within groups with time were assessed using analysis for repeated measurements. Data were presented as means±SD unless otherwise specified. P
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