Nosocomial infections in infants and children after cardiac surgery

被引：7

作者：

Hasija S. ^{[1
]}

Makhija N. ^{[1
,4
]}

Kiran U. ^{[1
]}

Choudhary S.K. ^{[2
]}

Talwar S. ^{[2
]}

Kapil A. ^{[3
]}

机构：

[1] Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, Ansari Nagar, New Delhi

[2] Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi

[3] Department of Microbiology, Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi

[4] Department of Cardiac Anaesthesia 7th Floor, Cardiothoracic Centre All India Institute of Medical Sciences Ansari Nagar, New Delhi

来源：

Indian Journal of Thoracic and Cardiovascular Surgery | 2008年 / 24卷 / 4期

关键词：

Antibiotics; Cardiac surgery; Congenital heart disease;

D O I：

10.1007/s12055-008-0052-y

中图分类号：

学科分类号：

摘要：

Objective: To identify the incidence, characteristics and risk factors of nosocomial infections (NIs) in infants and children undergoing open heart surgery, a prospective observational study. Methods: One hundred consecutive infants and children & 2 yrs of age undergoing open heart surgery (OHS) between March 2007 and December 2007 were included in the study. Samples for blood, endotracheal and urine culture were drawn daily during intensive care unit (ICU) stay. Cultures from endotracheal tube, central venous catheter, arterial cannula, chest tube, urinary catheter and other invasive lines were also obtained. Centers for Disease Control and Prevention criteria were used for defining NIs. A number of possible risk factors predisposing to NI were analyzed. Results: 32% patients developed NI. The NI rate was 49%. Common NIs were bloodstream infection (19%), respiratory tract infection (17%), catheter site infection (7%) and urinary tract infection (6%). Common pathogens were Acinetobacter (22.5%), Pseudomonas aeruginosa (20.4%), Klebsiella pneumoniae (16.3%) and Staphylococcus aureus (12.2%). Major risk factors for NI were length of ICU stay (p & 0.001), duration of intubation (p & 0.001), reintubation (p & 0.001), duration of central venous catheterization (p = 0.001), preoperative congestive heart failure (p = 0.002), tracheostomy (p = 0.003), duration of preoperative stay (p = 0.01), blood transfusion (p = 0.01), preoperative balloon atrial septostomy (p = 0.02), duration of surgery (p = 0.03), surgical complexity score (p = 0.03) and hypothermia (p = 0.03). The mortality rate was 11% with significant association between NI and death (p = 0.002). Conclusion: NIs develop frequently in infants and children after OHS. This study may serve as a reference point for further development and implementation of interventions aimed at reducing NI rates and improving patient outcome. © 2008 Indian Association of Cardiovascular-Thoracic Surgeons.

引用

页码：233 / 239

页数：6

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