{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T22:48:10Z","timestamp":1790635690242,"version":"4.1.0"},"reference-count":55,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T00:00:00Z","timestamp":1644796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Surgical site infections (SSIs), which are a potential complications in surgical procedures, are associated with prolonged hospital stays and increased postoperative mortality rates, and they also have a significant economic impact on health systems. Data in literature regarding risk factors for SSIs in pediatric age are scarce, with consequent difficulties in the management of SSI prophylaxis and with antibiotic prescribing attitudes in the various surgical procedures that often tend to follow individual opinions. The lack of pediatric studies is even more evident when we consider surgeries performed in subjects with underlying conditions that may pose an increased risk of complications. In order to respond to this shortcoming, we developed a consensus document to define optimal surgical antimicrobial prophylaxis (SAP) in neonates and children with specific high-risk conditions. These included the following: (1) colonization by methicillin-resistant Staphylococcus aureus (MRSA) and by multidrug resistant (MDR) bacteria other than MRSA; (2) allergy to first-line antibiotics; (3) immunosuppression; (4) splenectomy; (5) comorbidity; (6) ongoing antibiotic therapy or prophylaxis; (7) coexisting infection at another site; (8) previous surgery in the last month; and (9) presurgery hospitalization lasting more than 2 weeks. This work, made possible by the multidisciplinary contribution of experts belonging to the most important Italian scientific societies, represents, in our opinion, the most up-to-date and comprehensive collection of recommendations relating to behaviors to be undertaken in a perioperative site in the presence of specific categories of patients at high-risk of complications during surgery. The application of uniform and shared protocols in these high-risk categories will improve surgical practice with a reduction in SSIs and consequent rationalization of resources and costs, as well as being able to limit the phenomenon of antimicrobial resistance.<\/jats:p>","DOI":"10.3390\/antibiotics11020246","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T20:26:42Z","timestamp":1644870402000},"page":"246","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Surgical Antimicrobial Prophylaxis in Neonates and Children with Special High-Risk Conditions: A RAND\/UCLA Appropriateness Method Consensus Study"],"prefix":"10.3390","volume":"11","author":[{"given":"Sonia","family":"Bianchini","sequence":"first","affiliation":[{"name":"Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Rigotti","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Nicoletti","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Monaco","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinzia","family":"Auriti","sequence":"additional","affiliation":[{"name":"Neonatology and Neonatal Intensive Care Unit, IRCCS Bambino Ges\u00f9 Children\u2019s Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5336-8429","authenticated-orcid":false,"given":"Elio","family":"Castagnola","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, IRCCS Giannina Gaslini, 16147 Genoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Castelli Gattinara","sequence":"additional","affiliation":[{"name":"Unit of Immune and Infectious Diseases, IRCCS Bambino Gesu\u2019 Children\u2019s Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7549-3514","authenticated-orcid":false,"given":"Maia","family":"De Luca","sequence":"additional","affiliation":[{"name":"Unit of Immune and Infectious Diseases, IRCCS Bambino Gesu\u2019 Children\u2019s Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7912-3366","authenticated-orcid":false,"given":"Luisa","family":"Galli","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Meyer Children\u2019s Hospital, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5773-5356","authenticated-orcid":false,"given":"Silvia","family":"Garazzino","sequence":"additional","affiliation":[{"name":"Paediatric Infectious Diseases Unit, Regina Margherita Children\u2019s Hospital, University of Turin, 10122 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8026-0715","authenticated-orcid":false,"given":"Stefania","family":"La Grutta","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lancella","sequence":"additional","affiliation":[{"name":"Paediatric and Infectious Disease Unit, Academic Department of Pediatrics, IRCCS Bambino Ges\u00f9 Children\u2019s Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4181-6842","authenticated-orcid":false,"given":"Andrea","family":"Lo Vecchio","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Via D. Montesano 49, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4497-1872","authenticated-orcid":false,"given":"Giuseppe","family":"Maglietta","sequence":"additional","affiliation":[{"name":"Research and Innovation Unit, University Hospital of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5950-4965","authenticated-orcid":false,"given":"Carlotta","family":"Montagnani","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Meyer Children\u2019s Hospital, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2585-7567","authenticated-orcid":false,"given":"Nicola","family":"Petrosillo","sequence":"additional","affiliation":[{"name":"Infectious Disease and Infection Control Unit, Campus Bio-Medico, Medicine University Hospital, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-4422","authenticated-orcid":false,"given":"Carlo","family":"Pietrasanta","sequence":"additional","affiliation":[{"name":"NICU, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Department of Mother, Child and Infant, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3468-5568","authenticated-orcid":false,"given":"Nicola","family":"Principi","sequence":"additional","affiliation":[{"name":"Universit\u00e0 degli Studi di Milano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Simonini","sequence":"additional","affiliation":[{"name":"Unit of Immune and Infectious Diseases, IRCCS Bambino Gesu\u2019 Children\u2019s Hospital, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simonetta","family":"Tesoro","sequence":"additional","affiliation":[{"name":"Division of Anesthesia, Analgesia, and Intensive Care, Department of Surgical and Biomedical Sciences, University of Perugia, 06129 Perugia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0048-3933","authenticated-orcid":false,"given":"Elisabetta","family":"Venturini","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Unit, Meyer Children\u2019s Hospital, 50139 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Piacentini","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5877-440X","authenticated-orcid":false,"given":"Mario","family":"Lima","sequence":"additional","affiliation":[{"name":"Paediatric Surgery, IRCCS Azienda Ospedaliera-Universitaria di Bologna, 40138 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Staiano","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Via D. Montesano 49, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Esposito","sequence":"additional","affiliation":[{"name":"Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the Peri-Operative Prophylaxis in Neonatal and Paediatric Age (POP-NeoPed) Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1001\/jamasurg.2017.0904","article-title":"Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017","volume":"152","author":"Umscheid","year":"2017","journal-title":"JAMA Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1086\/676022","article-title":"Strategies to prevent surgical site infections in acute care hospitals: 2014 update","volume":"35","author":"Anderson","year":"2014","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1111\/pan.12436","article-title":"Retrospective evaluation of antimicrobial prophylaxis in prevention of surgical site infection in the pediatric population","volume":"24","author":"Shah","year":"2014","journal-title":"Paediatr. Anaesth."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1097\/SLA.0000000000000938","article-title":"SickKids Surgical Site Infection Task Force. Antibiotic Prophylaxis to Prevent Surgical Site Infections in Children: A Prospective Cohort Study","volume":"262","author":"Khoshbin","year":"2015","journal-title":"Ann. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1089\/sur.2013.9999","article-title":"American Society of Health-System Pharmacists (ASHP); Infectious Diseases Society of America (IDSA); Surgical Infection Society (SIS); Society for Healthcare Epidemiology of America (SHEA). Clinical practice guidelines for antimicrobial prophylaxis in surgery","volume":"14","author":"Bratzler","year":"2013","journal-title":"Surg. Infect."},{"key":"ref_6","unstructured":"Fitch, K., Bernstein, S.J., and Aguilar, M.D. (2001). The RAND\/UCLA Adeguateness Method User\u2019s Manual, The RAND Corporation."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1136\/bmj.309.6956.730","article-title":"Some observations on attempts to measure appropriateness of care","volume":"309","author":"Hicks","year":"1994","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/j.1469-0691.2011.03570.x","article-title":"Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: An international expert proposal for interim standard definitions for acquired resistance","volume":"18","author":"Magiorakos","year":"2012","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jiph.2016.08.007","article-title":"Antibiotic resistance","volume":"10","author":"Frieri","year":"2017","journal-title":"J. Infect. Public Health"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"18033","DOI":"10.1038\/nrdp.2018.33","article-title":"Methicillin-resistant Staphylococcus aureus","volume":"4","author":"Lee","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_11","unstructured":"World Health Organization (WHO) (2021, December 06). WHO Publishes List of Bacteria for Which New Antibiotics Are Urgently Needed. Available online: https:\/\/www.who.int\/news\/item\/27-02-2017-who-publishes-list-of-bacteria-for-which-new-antibiotics-are-urgently-needed."},{"key":"ref_12","unstructured":"World Health Organization (WHO) (2018). Global Guidelines for the Prevention of Surgical Site Infection, [2nd ed.]. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/277399."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.athoracsur.2017.03.018","article-title":"Preoperative Staphylococcus Aureus Screening and Targeted Decolonization in Cardiac Surgery","volume":"104","author":"Saraswat","year":"2017","journal-title":"Ann. Thorac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1097\/01.CCM.0000269027.50834.FE","article-title":"Effects of controlled perioperative antimicrobial prophylaxis on infectious outcomes in pediatric cardiac surgery","volume":"35","author":"Kato","year":"2007","journal-title":"Crit. Care Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1007\/s11999-008-0225-4","article-title":"A preoperative decolonization protocol for staphylococcus aureus prevents orthopaedic infections","volume":"466","author":"Rao","year":"2008","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.asj.2009.01.010","article-title":"Methicillin-sensitive and methicillin-resistant Staphylococcus aureus: Preventing surgical site infections following plastic surgery","volume":"29","author":"Elward","year":"2009","journal-title":"Aesthet. Surg. J."},{"key":"ref_17","unstructured":"(2021, December 12). ECDC Technical Report. Systematic Review of the Effectiveness of Infection Control Measures to Prevent the Transmission of Extended-Spectrum Betalactamase-Producing Enterobacteriaceae through Cross-Border Transfer of Patients. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/systematic-review-effectiveness-infection-control-measures-prevent-transmission-0."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.idc.2020.10.010","article-title":"Decolonization of Staphylococcus aureus","volume":"35","author":"Sharara","year":"2021","journal-title":"Infect. Dis. Clin. N. Am."},{"key":"ref_19","first-page":"CD006216","article-title":"Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers","volume":"4","author":"Bonten","year":"2008","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S101","DOI":"10.1016\/j.arth.2017.01.012","article-title":"Screening for Beta-Lactam Allergy in Joint Arthroplasty Patients to Improve Surgical Prophylaxis Practice","volume":"32","author":"McDanel","year":"2017","journal-title":"J. Arthroplast."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1093\/cid\/cix794","article-title":"The Impact of a Reported Penicillin Allergy on Surgical Site Infection Risk","volume":"66","author":"Blumenthal","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/j.jpedsurg.2014.10.048","article-title":"Penicillin allergy and surgical prophylaxis: Cephalosporin cross-reactivity risk in a pediatric tertiary care center","volume":"50","author":"Beltran","year":"2015","journal-title":"J. Pediatr. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1017\/ice.2018.244","article-title":"Variability of surgical prophylaxis in penicillin-allergic children","volume":"39","author":"Butler","year":"2018","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2623","DOI":"10.1016\/j.jhsa.2012.06.038","article-title":"Preoperative antibiotic prophylaxis in the penicillin-allergic patient","volume":"37","author":"Osei","year":"2012","journal-title":"J. Hand Surg. Am."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"S67","DOI":"10.1016\/S0929-693X(13)71410-6","article-title":"Antibiotic prophylaxis in visceral and urologic p\u00e6diatric surgery","volume":"20","author":"Haas","year":"2013","journal-title":"Arch. Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Tiri, A., Masetti, R., Conti, F., Tignanelli, A., Turrini, E., Bertolini, P., Esposito, S., and Pession, A. (2021). Inborn Errors of Immunity and Cancer. Biology, 10.","DOI":"10.3390\/biology10040313"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"185","DOI":"10.2298\/ACI1102185N","article-title":"Preoperative assesment of the immunocompromised patient","volume":"58","year":"2011","journal-title":"Acta Chir Iugosl."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"115220","DOI":"10.1016\/j.diagmicrobio.2020.115220","article-title":"Surgical site infection after liver transplantation in the era of multidrug-resistant bacteria: What new risks should be considered?","volume":"99","author":"Freire","year":"2021","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Zhang, L., Liu, B.-C., Zhang, X.-Y., Li, L., Xia, X.-J., and Guo, R.-Z. (2012). Prevention and treatment of surgical site infection in HIV-infected patients. BMC Infect. Dis., 12.","DOI":"10.1186\/1471-2334-12-115"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Muneer, A., Pearce, I., and Ralph, D. (2016). Prosthetic Surgery in Urology, Springer.","DOI":"10.1007\/978-3-319-13859-6"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1007\/s15010-009-8225-1","article-title":"Surgical site infections in HIV-infected patients: Results from an Italian prospective multicenter observational study","volume":"37","author":"Drapeau","year":"2009","journal-title":"Infection"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s11748-011-0808-y","article-title":"Effect of CD4+ T-lymphocyte count on hospital outcome of elective general thoracic surgery patients with human immunodeficiency virus","volume":"59","author":"Nagasaka","year":"2011","journal-title":"Gen. Thorac Cardiovasc. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Esposito, C., Hollands, C., Lima, M., Settimi, A., and Valla, J.-S. (2010). Splenectomia totale\/splenectomia parziale. Videochirurgia Pediatrica: Principi di Tecnica in Laparoscopia, Toracoscopia e Retroperitoneoscopia Pediatrica, Springer.","DOI":"10.1007\/978-88-470-1797-9"},{"key":"ref_34","unstructured":"Russello, D., and La Greca, G. (2021, December 06). CINECA IRIS, Institutional Research Information Sysetem. Splenectomia Laparoscopica: Quali Evidenze?. Available online: https:\/\/www.iris.unict.it\/handle\/20.500.11769\/91194."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1007\/s00431-019-03424-6","article-title":"Emergency or urgent splenectomy in children for non-traumatic reasons","volume":"178","author":"Samuk","year":"2019","journal-title":"Eur. J. Pediatr."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Clavien, P.A., Sarr, M.G., Fong, Y., and Georgiev, P. (2007). Open Splenectomy. Atlas of Upper Gastrointestinal and Hepato-Pancreato-Biliary Surgery, Springer.","DOI":"10.1007\/978-3-540-68866-2"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1055\/s-0031-1295691","article-title":"Impact of obesity on surgical site infection in colon and rectal surgery","volume":"24","author":"Hourigan","year":"2011","journal-title":"Clin. Colon Rectal Surg."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Skeie, E., Koch, A.M., Harthug, S., Fosse, U., Sygnestveit, K., Nilsen, R.M., and Tangvik, R.J. (2018). A positive association between nutritional risk and the incidence of surgical site infections: A hospital-based register study. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0197344"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.jhin.2019.04.020","article-title":"Association of malnutrition with periprosthetic joint and surgical site infections after total joint arthroplasty: A systematic review and meta-analysis","volume":"103","author":"Tsantes","year":"2019","journal-title":"J. Hosp. Infect."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1093\/clind\/24.4.669","article-title":"Infective endocarditis: 35 years of experience at a children\u2019s hospital","volume":"24","author":"Martin","year":"1997","journal-title":"Clin. Infect. Dis."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1487","DOI":"10.1161\/CIR.0000000000000298","article-title":"American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee of the Council on Cardiovascular Disease in the Young and the Council on Cardiovascular and Stroke Nursing. Infective Endocarditis in Childhood: 2015 Update: A Scientific Statement from the American Heart Association","volume":"132","author":"Baltimore","year":"2015","journal-title":"Circulation"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1097\/PEC.0000000000001628","article-title":"Infectious Endocarditis Prophylaxis in Children","volume":"34","author":"Martin","year":"2018","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.surge.2010.07.011","article-title":"Surgery induced immunosuppression","volume":"9","author":"Hogan","year":"2011","journal-title":"Surgeon"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1002\/bjs.1800800224","article-title":"Changes in major histocompatibility complex class II expression in monocytes and T cells of patients developing infection after surgery","volume":"80","author":"Wakefield","year":"1993","journal-title":"Br. J. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1097\/01.ccx.0000235210.85073.fc","article-title":"The inflammatory response to surgery and trauma","volume":"12","author":"Kohl","year":"2006","journal-title":"Curr. Opin. Crit. Care"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1055\/s-0029-1241192","article-title":"Metabolic response to surgery in infants and children","volume":"19","author":"McHoney","year":"2009","journal-title":"Eur. J. Pediatr. Surg."},{"key":"ref_47","first-page":"310","article-title":"Risk factors for surgical-wound infection in general surgery: A prospective study","volume":"18","year":"1997","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_48","first-page":"457","article-title":"Surgical Site Infection: Re-assessment of the Risk Factors","volume":"110","author":"Isik","year":"2015","journal-title":"Chirurgia"},{"key":"ref_49","first-page":"253","article-title":"Review of the use of cephalosporins in children with anaphylactic reactions from penicillins","volume":"13","author":"Hameed","year":"2002","journal-title":"Can. J. Infect. Dis."},{"key":"ref_50","first-page":"129","article-title":"Overweight and obesity in children and adolescents","volume":"6","year":"2014","journal-title":"J. Clin. Res. Pediatr. Endocrinol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Strobel, R.M., Leonhardt, M., F\u00f6rster, F., Neumann, K., Lobbes, L.A., Seifarth, C., Lee, L.D., Schineis, C.H.W., Kamphues, C., and Weixler, B. (2021). The impact of surgical site infection-a cost analysis. Langenbecks. Arch. Surg.","DOI":"10.1007\/s00423-021-02346-y"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Shaaban, R.H., Yassine, O.G., Bedwani, R.N., and Abu-Sheasha, G.A. (2021). Evaluation of the costing methodology of published studies estimating costs of surgical site infections: A systematic review. Infect. Control Hosp. Epidemiol.","DOI":"10.1017\/ice.2021.381"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"712461","DOI":"10.3389\/fpubh.2021.712461","article-title":"The Socioeconomic Impact of Surgical Site Infections","volume":"9","author":"Piednoir","year":"2021","journal-title":"Front. Public Health"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"e057468","DOI":"10.1136\/bmjopen-2021-057468","article-title":"Cost-effectiveness analysis of an active 30-day surgical site infection surveillance at a tertiary hospital in Ghana: Evidence from HAI-Ghana study","volume":"12","author":"Otieku","year":"2022","journal-title":"BMJ Open"},{"key":"ref_55","first-page":"e19962","article-title":"Incidence, Risk Factors, and Mortality from Hospital-Acquired Infections at a Hospital in Mauritius","volume":"13","author":"Nuckchady","year":"2021","journal-title":"Cureus"}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/2\/246\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:19:11Z","timestamp":1760134751000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/11\/2\/246"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,14]]},"references-count":55,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["antibiotics11020246"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics11020246","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,14]]}}}