Halepota Huma Faiz, Zeng Emily, Mothi Suraj Sarvode, Zaghloul Tarek M, Gehle Daniel B, Nwachukwu Ijeoma, Houston Mary Beth, Lynn Matthew Joseph, Crouzen Emile, Lakshminarayanan Bhanumathi, Murphy Andrew Jackson
Department of Surgery, 262 Danny Thomas Place, St Jude Children's Research Hospital Memphis, Tennessee 38105, USA.
Department of Biostatistics, 262 Danny Thomas Place, St. Jude Children's Research Hospital, Memphis, TN 38105, USA.
J Pediatr Surg. 2025 Feb;60(2):162008. doi: 10.1016/j.jpedsurg.2024.162008. Epub 2024 Oct 19.
There is no consensus on the perioperative use of antibiotics in pediatric solid tumor resection. This study collected data from two pediatric centers that utilize perioperative antibiotics to varying degrees in pediatric solid tumor patients to investigate the occurrence of postoperative sepsis and infectious complications.
A two-institution, retrospective cohort study was performed. Charts of children who underwent solid tumor resection between July 2018-June 2021 were reviewed. Patient characteristics, diagnosis, operative data, perioperative antibiotic use, and postoperative infection/sepsis were analyzed within 30 days of surgery. The primary outcome was surgical site infection (SSI) or systemic sepsis within 30 days of surgery. Fisher's tests were performed to evaluate differences.
250 patients underwent tumor resection between July 2018 and June 2021 at both centers. The median age was 4 years [Range: 0.02-26.1]. Seventy-five percent (N = 188) received perioperative antibiotics prophylaxis (AP), while 25 % of patients did not receive AP (N = 62). Only one patient in the AP group (0.5 %) developed postoperative sepsis, while 12 patients (19.4 %) in the non-AP group developed sepsis (p < 0.0001). There were 3 SSI in the AP group and none in the non-AP group (p = 1.0).
The administration of AP in children undergoing solid tumor resection is associated with a reduced rate of postoperative sepsis but no difference in SSI. This could possibly be related to bacterial translocation during surgery and the seeding of indwelling central venous access catheters. Our results support the standardized use of AP in this population.
Retrospective Cohort Study.
III.
小儿实体肿瘤切除术中围手术期抗生素的使用尚无共识。本研究收集了两个儿科中心的数据，这两个中心在小儿实体肿瘤患者中不同程度地使用围手术期抗生素，以调查术后脓毒症和感染并发症的发生情况。
进行了一项双机构回顾性队列研究。回顾了2018年7月至2021年6月期间接受实体肿瘤切除术的儿童病历。在术后30天内分析患者特征、诊断、手术数据、围手术期抗生素使用情况以及术后感染/脓毒症。主要结局是术后30天内的手术部位感染（SSI）或全身性脓毒症。采用Fisher检验评估差异。
两个中心在2018年7月至2021年6月期间共有250例患者接受了肿瘤切除术。中位年龄为4岁[范围：0.02 - 26.1岁]。75%（N = 188）的患者接受了围手术期抗生素预防（AP），而25%的患者未接受AP（N = 62）。AP组中只有1例患者（0.5%）发生术后脓毒症，而非AP组中有12例患者（19.4%）发生脓毒症（p < 0.0001）。AP组有3例SSI病例，非AP组无SSI病例（p = 1.0）。
小儿实体肿瘤切除术中使用AP与术后脓毒症发生率降低相关，但与SSI无差异。这可能与手术期间细菌移位以及留置中心静脉通路导管的定植有关。我们的结果支持在该人群中规范使用AP。
回顾性队列研究。
III级。
