Incidence and clinical factors related with nosocomial infection in children with heart surgery
Main Article Content
Keywords
Cross Infection, Thoracic Surgery, Disease Transmission, Infectious
Abstract
Background: the risk of nosocomial infection in pediatric patients undergoing heart surgery is high and proportional to the days of stay, mainly in intensive care units. Our objective was to determine the incidence and associated factors to nosocomial infections after a heart surgery.
Methods: descriptive, retrospective clinical study with 64 pediatric patients who underwent a heart surgery. The χ2 with Yates fix for nonparametric data test, relative risk, as well as incidence rate were performed.
Results: nosocomial infection prevalence rate was 52; fatality in infected 21.2, rate not infected of 16.1; the type of nosocomial infection with the highest rate of 65.6 was pneumonia, and the most common microorganism (rate 12.5) was Candida. The largest number of infection events were 24 with a 37.5 rate. The most significant variables for infection were heart surgery, parenteral nutrition, nasogastric intubation and tracheotomy.
Conclusions: the pediatric patients undergoing a heart surgery presented nosocomial infection in half of the cases and the fatality rate was higher than the rate reported in literature.
References
Castillo VR, Jaramillo GA, Andrade OM, Montero A, Salazar L, Sanabria J, et al. Mortalidad quirúrgica de la corrección de las cardiopatías congénitas en la Fundación Cardiovascular de Colombia 2000-2005. Rev Colom Cardiol. 2006; 13:132-135. Disponible en http://www.scielo.unal. edu.co/scielo.php?pid=S0120-56332006000500016 &script=sci_arttext
Massin M, Dessy H. Delayed recognition of congenital heart disease. Postgraduate Med J. 2006;82 (969):468-470.
Ramírez M, Calderón C. Cirugía de las cardiopatías congénitas complejas. Arch Cardiol Mex. 2003;73(Suppl 1):128-132.
Mrowczynski W, Woftalik M, Zawoolzka D, Sharma G, Henschke J, et al. Infection risk factors in pediatric cardiac surgery. Asian Cardiovasc Thorac Ann. 2002;10(4):329-333.
Lopes JM, Tonelli E, Lamounier JA, Couto BR, Siqueira AL, Komatsuzaki F, et al. Prospective surveillance applying the national nosocomial infection surveillance methods in a Brazilian pediatric public hospital. Am J Infect Control. 2002;3(1):1-7.
Richards MJ, Edwards JR, Culver DH, Gaynmes RP. Nosocomial infections in pediatric intensive care units in the United States. Pediatrics. 1999; 103(4):39-45.
Molina G, Garza M, Vigilancia de infecciones nosocomiales en un hospital de cardiología. Salud Publica Mex. 1999;41(Supl 1):26-31.
Ávila-Figueroa C, Casthat-Cruz M, Aranda-Patrón E, León AR, Justiniani N, Pérez-Ricárdez L, et al. Prevalencia de infecciones nosocomiales en niños: encuesta de 21 hospitales en México. Salud Publica Mex. 1999;41:18-25.
Cavalcante SS, Mota E, Silva LR, Teixeira LF, Cavalcante LB. Risk factors for developing nosocomial infections among pediatric patients. Pediatr Infect Dis J. 2006;25(5):438-445.
Aguilar EM, García-López B, Hernández-Tezoquipa I, Rosas-Reséndiz MT. Las infecciones nosocomiales: registrar para prevenir. Rev Enferm IMSS. 2006;12(2):89-92.
Izquierdo-Cubas F, Zambrano A, Bastanzuri M, Malpica J. Prevalencia nacional de infecciones nosocomiales. Cuba 1997. Rev Panam Infectol. 2006;8 (1):39-44.
Aibar-Remón C, Rabanaque-Hernández MJ, Gómez-López I. Infección nosocomial en pacientes quirúrgicos. Problemas de medición y de comparación de resultados. Rev Esp Salud Publica. 1997;71(34):757-768. Disponible en http://scielo.isciii.es/scielo.php?script=sci_arttext& pid=S1135-57271997000300005&lng=es.
Urrea M, Pons M. Serra M, Latorre C, Palomeque A. Prospective incidence study of nosocomial infections in a pediatric intensive care unit. Pediatr Infect Dis. 2003;22(6):490-494.
Bravo P, Miranda PY, Oliva PM, Lambert MJ, Manchado SO, Ozores SJ. Factores de riesgo de infección nosocomial después de cirugía cardiaca pediátrica. Rev Cubana Pediatr 2006;78 (3):1-7. Disponible en http://scielo.sld.cu/scielo. php?script=sci_arttext&pid=S0034-7531200600 0300002&lng=es
Bravo PL, Lambert MJ, Barrial MJ, Miranda PY. Infecciones nosocomiales después de cirugía cardiaca pediátrica: incidencia, microorganismos y resultados finales. Rev Cubana Med Int Emerg. 2009;8(1):1444-1454. Disponible en http://bvs. sld.cu/revistas/mie/vol8_1_09/mie08109.pdf
Dagan O, Cox PN, Ford-Jones L, Ponsonby J, Bohn DJ. Nosocomial infections following cardiovascular surgery: comparison of two periods, 1987 vs. 1992. Crit Care Med. 1999;27(1):104-108.
Levy I, Ovadia B, Erez E, Rinat S, Ashkenazi S, Birk E, et al. Nosocomial infections after cardiac surgery in infants and children: incidence and risk factors. J Hosp Infect. 2003;53(2):111-116.
Valera M, Scalforo C, Cappello N, Gramaglia E, Grassitelli S, Abbate MT, et al. Nosocomial infections in pediatric cardiac surgery, Italy. Infect Control Hosp Epidemiol. 2001;22(12):771-775.