Document Detail


Impact of bloodstream infection on the outcome of children undergoing cardiac surgery.
MedLine Citation:
PMID:  20063161     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Bloodstream infections (BSIs) are a main cause of nosocomial infection in the critical care area. The development of BSI affects the surgical outcome and increases intensive care unit (ICU) morbidity and mortality. This prospective cohort study was undertaken to determine the incidence, etiology, risk factors, and outcome of BSI for postoperative pediatric cardiac patients in the pediatric cardiac ICU setup. All postoperative pediatric patients admitted to the pediatric cardiac ICU from January 2007 to December 2007 were included in the study. Data were prospectively collected using a standardized data collection form. Patients with BSI (group 1) were compared with non-BSI patients (group 2) in terms of age, weight, surgical complexity score, duration of central line, need to keep the chest open postoperatively, and the length of the pediatric cardiac ICU and hospital stay. Of the 311 patients who underwent cardiac surgery during the study period, 27 (8.6%) were identified as having BSI (group 1). The 311 patients included in the study had a total of 1,043 central line days and a catheter-related BSI incidence density rate of 25.8 per 1,000 central line days. According to univariate analysis, the main risk factors for the development of BSI after pediatric cardiac surgery were lower patient weight (p = 0.005), high surgical complexity score (p < 0.05), open sternum postoperatively (p < 0.05), longer duration of central lines (p < 0.0001), and prolonged pediatric cardiac ICU and hospital stay (p < 0.0001). Gram-negative organisms were responsible for 67% of the BSI in the pediatric cardiac ICU, with pseudomonas (28%) and enterobacter (22%) as the main causative organisms. The mortality rate in the BSI group was 11% compared with 2% in the non-BSI group. In our pediatric cardiac ICU, BSI developed in 8.6% of the children undergoing cardiac surgery, mainly caused by a Gram-negative organism. The main risk factors for BSI in the postoperative pediatric cardiac patient were high surgical complexity, open sternum, low body weight, longer duration of central line, and prolonged pediatric cardiac ICU stay.
Authors:
Raja Abou Elella; Hani K Najm; Hanan Balkhy; Lily Bullard; Mohamed S Kabbani
Publication Detail:
Type:  Journal Article     Date:  2010-01-10
Journal Detail:
Title:  Pediatric cardiology     Volume:  31     ISSN:  1432-1971     ISO Abbreviation:  Pediatr Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-23     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003849     Medline TA:  Pediatr Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  483-9     Citation Subset:  IM    
Affiliation:
Cardiac Sciences Department, King Abdulaziz Medical City, Mail Code 1413, PO Box 22490, Riyadh 11426, Saudi Arabia. rabouelella@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Antibiotic Prophylaxis
Bacteremia / etiology,  mortality*
Catheterization, Central Venous / adverse effects
Catheters, Indwelling / microbiology
Cohort Studies
Cross Infection / etiology,  mortality*
Cross-Sectional Studies
Enterobacter
Enterobacteriaceae Infections / etiology,  mortality
Female
Fungemia / etiology,  mortality*
Gram-Negative Bacterial Infections / etiology,  mortality
Heart Defects, Congenital / mortality,  surgery*
Hospital Mortality
Humans
Infant
Infant, Newborn
Intensive Care Units, Pediatric / statistics & numerical data*
Length of Stay / statistics & numerical data
Male
Postoperative Complications / etiology,  mortality*
Prospective Studies
Pseudomonas Infections / etiology,  mortality
Risk Factors
Saudi Arabia
Surgical Wound Infection / etiology,  mortality
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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