Surgical site infection in pediatric scoliosis surgery: Microbiological profile and antimicrobiological resistance
DOI:
https://doi.org/10.58814/01208845.757Keywords:
Scoliosis, Postoperative Complications, Surgical Wound Infection, Drug Resistance, MicrobialAbstract
Introduction: Pediatric scoliosis may require surgical correction, a procedure that carries a risk of surgical site infection (SSI). These infections are most caused by Gram-positive bacteria, particularly Staphylococcus aureus, with clinically significant rates of methicillin resistance.
Objective: To characterize SSI in pediatric patients undergoing surgical correction for scoliosis and to analyze the etiological agents and their antimicrobial resistance profiles at a tertiary referral center for pediatric orthopedics and spine surgery in Bogotá, Colombia.
Methodology: Retrospective case series was conducted in pediatric patients with SSI following surgical correction of scoliosis at a specialized center in Colombia between 2017 and 2023. A descriptive analysis of clinical, surgical, and microbiological characteristics was performed.
Results: A total of 1 018 records were reviewed, and 24 cases of SSI were included, yielding an incidence of 2.36%. Neuromuscular scoliosis accounted for 41.67% of cases, while early SSI accounted for 58.33%. Implant removal was required in 70.83% of patients. Twenty-eight isolates were obtained, with Gram-positive organisms predominating (60.71%). Staphylococcus aureus was the most frequent pathogen (50%), with methicillin resistance observed in 21.43%, it remained as the predominant pathogen in late SSI (9/10; 90%). Among Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa were the most frequently isolated. Polymicrobial cultures accounted for 12.50% of cases. The median time to diagnosis was 50 days, with most infections identified within the first postoperative month.
Conclusions: SSI following pediatric scoliosis correction remain a significant clinical challenge, with Staphylococcus aureus as the predominant pathogen and clinically relevant antimicrobial resistance. Optimized strategies for prevention, diagnosis, and treatment are required to improve clinical outcomes.
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