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Hospital pneumonia following cardiac surgery in children
N Jashiashvili1, A Nanuashvili
1Georgian State Medical Academy; Jo Ann Pediatric Cardiac Surgery Clinic, Tbilisi, Georgia.
Insights
Hospital pneumonia is a significant risk after pediatric cardiac surgery. Emergency operations and reoperations notably increase the incidence of hospital-acquired pneumonia in these young patients.
Area of Science:
- Pediatric Cardiac Surgery
- Hospital-Acquired Infections
- Infectious Disease Epidemiology
Background:
- Cardiovascular surgery poses a high risk for hospital infections, with hospital pneumonia being a leading cause of morbidity and mortality.
- Understanding the specific risks and causes of hospital pneumonia in pediatric cardiac surgery patients is crucial for developing targeted prevention strategies.
Purpose of the Study:
- To determine the frequency and etiological agents of hospital pneumonia following pediatric cardiac surgery.
- To investigate whether emergency operations and reoperations increase the incidence of hospital pneumonia in this population.
Main Methods:
- A retrospective study of 355 pediatric patients undergoing cardiac surgery between January 2002 and December 2004.
- Analysis of patient demographics, operation types (primary vs. reoperation, planned vs. emergency), and occurrence of hospital-acquired infections, specifically pneumonia.
- Identification of causative pathogens through microbiological analysis.
Main Results:
- Hospital-acquired infection occurred in 11.9% of patients, with pneumonia being the most common complication (5.1%).
- Pneumonia was frequently associated with mechanical ventilation (77.8%).
- Gram-negative bacteria (60%), particularly Stenotrophomonas maltophilia, were the most common cause, followed by gram-positive bacteria (20%), primarily Staphylococcus aureus, and fungi (20%), mainly Aspergillus spp.
- The rate of hospital pneumonia was significantly higher in emergency operations and reoperations.
Conclusions:
- Hospital pneumonia is a considerable complication after pediatric cardiac surgery, with specific bacterial and fungal pathogens identified.
- Emergency and reoperative cardiac surgeries are associated with a significantly increased risk of developing hospital pneumonia in children.
- These findings highlight the need for enhanced infection control measures and vigilant monitoring in pediatric cardiac surgery patients, especially those undergoing urgent or repeat procedures.
Abstract:
Any massive surgical intervention, especially cardiovascular surgery creates high risk for the development of hospital infections. Hospital pneumonia is the major cause of morbidity and mortality. The aim of our study was to determine the frequency and etiology of hospital pneumonia following cardiac surgery in children and to find out whether the emergency operations and reoperations increase the frequency of hospital pneumonia. We studied 355 patients in Jo Ann Pediatric Cardiac Surgery Clinic, who were operated in the period from January 2002 till December 2004. The age of the patients varied from 1 day to 18 years. Out of 355 operations 290 were primary ones, 65 reoperations. In 320 cases the operations were planed, 35 cases-emergency ones. Out of 355 patients, hospital infection occurred in 42 (11,9%) cases. The most common infectious complication was pneumonia that made up 18 cases (5,1%). In 77,8% of cases pneumonia was associated with mechanical ventilation. Hospital pneumonia in 60% were caused by gram-negative, in 20% -- by gram-positive bacteria and in 20% -- by fungi. The most frequent gram-negative bacterium were nonfermenter gram-negative rods, among these pathogens Stenotrophomonas maltophilia was the most common and the most frequent gram-positive bacterium was Staphylococcus aureus. All three cases of fungal pneumonia were caused by Aspergillus spp. The rate of hospital pneumonia was significantly higher in the cases of emergency operations as well as reoperations.
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