Nosocomial infections after pediatric cardiac surgery

Background This study examined the rate of nosocomial infection (NI) in children who underwent cardiac surgery, and also investigated the impact of postdischarge infection surveillance. Risk factors for surgical site infections (SSIs) also were evaluated. Methods All patients who underwent open-heart cardiac surgery in the Hospital for Children and Adolescents, Helsinki University Central Hospital, Finland, between January 2000 and December 2002 were included. Data were collected retrospectively from hospital registries. A prospective postdischarge survey was conducted to detect SSIs arising within 30 days after surgery, as well as respiratory and gastrointestinal infections with onset within 3 days after discharge. Results The study included 614 procedures performed in 511 patients. A total of 80 NIs were found (overall NI rate, 6.3 per 1000 patient days), including 21 superficial and 6 deep SSIs. Multivariable analysis identified preoperative hospitalization > 48 hours and high American Society of Anesthesiologists (ASA) score as risk factors for SSI. The postdischarge study revealed 7 additional superficial SSIs, 29 respiratory infections, and 29 gastrointestinal infections; 12 patients required rehospitalization. Conclusions Almost 25% of the patients had at least 1 NI. All severe NIs were detected during the postoperative hospital stay. Respiratory and gastrointestinal infections were common and often led to rehospitalization, thus increasing costs.