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A Study on Nosocomial Infection after Pediatric Cardiac Surgery: Data from National Center for Cardiovascular Diseases in China
14 Pages Posted: 11 Dec 2023
More...Abstract
Background: Infection prevention and control (IPC) poses significant impact on prognosis after pediatric cardiac surgery. The past three years of COVID-19 epidemic have witnessed development in IPC in China. However, the IPC results in pediatric cardiac surgery have not been reported.
Methods: This was a single-center retrospective study, including pediatric patients who underwent cardiac surgery from 2021 to 2022. The results of postoperative bacterial and fungal culture and antimicrobial stewardship were collected. The demographic characteristics (age, weight), operation-related parameters (RACHS-1 grade, duration of cardiopulmonary bypass and aortic cross clamp) and surgical outcomes (extracorporeal membrane oxygenation, delayed sternal closure, mortality, duration of mechanical ventilation, length of intensive care unit stay, length of hospital stay, hospitalization costs) of multi-drug resistant organism (MDRO) and non-MDRO patients were compared.
Findings: A total of 4776 patients were included. There were 101 infectious culture results after operation, the nosocomial infection rate was 2·1%. There were 40 MDRO specimens in 36 patients, 50 non-MDRO specimens in 30 patients, 11 fungal specimens in 10 patients. The incidence of pneumonia was 1·5%, with ventilator associated pneumonia incidence density 7·2/1000 patient-days. The incidence of sepsis was 0·4%, with catheter-related bloodstream infection incidence density 0·24/ 1000 patient-days. The incidence density of catheter-associated urinary tract infection was 0·45/ 1000 patient-days. The incidence of surgical site infection was 0·06%. The culture proportion before commencing antibiotics was 93%, the antibiotic consumption intensity was 30·7 DDD/100 bed-days. The length of intensive care unit stay in MDRO infection patients increased comparing with non-MDRO infection patients, 30 (18,52) vs 17 (7,62) days, p=0·05.
Interpretation: The IPC performance in Fuwai hospital has achieved satisfactory results. Infection with MDRO can lead to prolonged intensive care unit stay.
Funding: This work was supported by the Clinical Research Foundation of National Health Commission of the People’s Republic of China.
Declaration of Interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Ethical Approval: The approval of the Fuwai hospital Ethics Committee was obtained in 2022, ID: 2022-1859. The ethical principles followed the 1975 Helsinki Declaration. This was a retrospective analysis based on anonymized data collected for routine clinical care and administrative purposes, so individual informed consent was waived.
Keywords: nosocomial infections, pediatric cardiac surgery, multidrug-resistant organism, surgical outcomes
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