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Prolonged candidemia in infants following surgery for congenital heart disease

Chandrama Chakrabarti1, Sunil K Sood, Vincent Parnell

  • 1Department of Pediatrics Schneider Children's Hospital, New Hyde Park, New York 11040, USA.

Infection Control and Hospital Epidemiology
|November 1, 2003
PubMed

Insights

Candidemia in infants with complex congenital heart disease (CCHD) after surgery is persistent and deadly. Long-term total parenteral nutrition (TPN) and intravascular thrombi are key risk factors.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Infants with complex congenital heart disease (CCHD) undergoing cardiac surgery face significant postoperative risks.
  • Candidemia, a serious fungal infection, can complicate recovery in this vulnerable population.

Purpose of the Study:

  • To characterize candidemia in infants with CCHD post-cardiac surgery.
  • To identify risk factors associated with candidemia in this patient group through a case-control study.

Main Methods:

  • Descriptive and case-control study design.
  • Inclusion of infants with CCHD who developed candidemia post-cardiac surgery.
  • Matching of control patients based on CCHD lesions, age, and postoperative hospital stay.

Main Results:

  • Six out of 95 infants (6.3%) developed prolonged candidemia (median 17 days) with diverse Candida species.
  • High mortality rate (83%) in infants with candidemia compared to controls (13%).
  • Multivariate analysis identified prolonged total parenteral nutrition (TPN) and intravascular thrombi as significant risk factors.

Conclusions:

  • Candidemia in infants with CCHD post-cardiac surgery is persistent and linked to high mortality.
  • The varied species suggest no common-source outbreak.
  • Prolonged TPN and intravascular thrombi are critical risk factors for candidemia in these infants.
Abstract

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