Surgical site infections: A prospective study in a pediatric surgery center in resource-limited setting

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Published Mar 10, 2026
https://doi.org/10.62438/tunismed.v104i01.6432
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Vol. 104 No. 01 (2026): Tunis Med Jan 2026

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Samia Belhassen
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Afef Toumi
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Myriam Ben Fredj
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Sana Mosbahi
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Sabrine Ben Youssef
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Imene Ben Hawala
Department of Hospital Hygiene and Sterilization, Fattouma Bourguiba University Hospital, Monastir, Tunisia
Sami Sfar
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Amine Ksia
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Mongi Mekki
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Mohsen Belghith
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia
Sawsen Chakroun
Department of Pediatric anesthesiology and reanimation,Research Laboratory LR12SP13, Fattouma Bourguiba University Hospital, Monastir ,Faculty of Medicine of Monastir, Tunisia
Lassaad Sahnoun
Department of Pediatric surgery, Research Laboratory LR12SP13, Fattouma Bourguiba University hospital, Monastir, Faculty of Medicine of Monastir, Tunisia

Abstract

Aim: This study aimed to measure the incidence of surgical site infections (SSI) in pediatric population, identify the primary characteristics and risk factors associated with SSI, and propose practical recommendations for controlling and preventing these infections.


Materials and Methods: A prospective study was conducted over a 4-month period from February 1 to June 1, 2024, in the Pediatric Surgery Department of Monastir. All patients admitted, operated on, and followed up in the department during this period were included, with specific exclusions. Data on patient demographics, surgical details, and outcomes were collected daily. Statistical analysis involved both univariate and multivariate approaches to identify significant risk factors.


Results: Among the 414 pediatric patients included in the study, the incidence of surgical site infection (SSI) was 3.3%, with an incidence density of 11.9 cases per 1,000 hospital days. The analysis of individual and surgical risk factors for SSI identified several significant associations: Neonates and infants (<2 years) were at higher risk (p=0.039), as were patients with drains (p=0.000) or gastric tubes. In terms of surgical risk factors, non-ambulatory surgeries (p=0.002), emergency procedures (p=0.013), surgeries classified as Altemeier class III or IV (13% vs. 2%, p=0.000), a higher NNIS score, and extended postoperative hospital stays compared to home discharges (p=0.001) were all associated with increased risk. Multivariate analysis revealed that the presence of a drain, age under 2 years, and an NNIS score of 1 or higher were independent risk factors for developing SSI....( abstract truncated at 250 words)

Keywords:

Surgical Site Infection, Health Care Associated Infection, Risk Factor, Child, Prevention

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