Related Experiment Videos
Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched
Daniel J Lex1, Roland Tóth, Zsuzsanna Cserép
1School of PhD Studies, Semmelweis University, Budapest, Hungary.
Insights
Postoperative infection risk factors in pediatric cardiac surgery patients were identified. Positive Staphylococcus aureus cultures and elevated C-reactive protein levels indicate a higher risk of infection conversion from colonization.
Area of Science:
- Pediatric cardiac surgery
- Infectious disease epidemiology
- Critical care medicine
Background:
- Pediatric cardiac surgery patients are susceptible to postoperative infections.
- Understanding the transition from colonization to infection is crucial for patient outcomes.
Purpose of the Study:
- To identify risk factors for the conversion of colonization to infection in pediatric cardiac surgery patients.
- To compare characteristics of patients with infection versus those with only positive cultures.
Main Methods:
- Retrospective analysis of 1665 pediatric cardiac surgery patients (2004-2008).
- Propensity score matching used to compare 141 infected patients with 141 colonized patients.
- Data included demographics, comorbidities, surgery details, lab results, and microbial data.
Main Results:
- 179 patients (9.3%) developed infection; 253 (15.2%) had colonization.
- Gram-positive species were more common in the colonization group.
- Higher C-reactive protein levels (postoperative days 1 & 2) and longer intensive care unit stays were observed in the infection group.
Conclusions:
- Positive Staphylococcus aureus and bloodstream results are independent risk factors for infection.
- Significant differences in postoperative C-reactive protein and white blood cell counts exist between infected and colonized patients.
Background:
The objective of this study was to identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery.
Methods:
Following approval from the Institutional Review Board, patient demographics, co-morbidities, surgery details, transfusion requirements, inotropic infusions, laboratory parameters and positive microbial results were recorded during the hospital stay, and the patients were divided into two groups: patients with clinical signs of infection and patients with only positive cultures but without infection during the postoperative period. Using propensity scores, 141 patients with infection were matched to 141 patients with positive microbial cultures but without signs of infection. Our database consisted of 1665 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between the patient group with infection and the group with colonization was analyzed after propensity score matching of the perioperative variables.
Results:
179 patients (9.3%) had infection, and 253 patients (15.2%) had colonization. The occurrence of Gram-positive species was significantly greater in the colonization group (p=0.004). The C-reactive protein levels on the first and second postoperative days were significantly greater in the infection group (p=0.02 and p=0.05, respectively). The sum of all the positive cultures obtained during the postoperative period was greater in the infection group compared to the colonization group (p=0.02). The length of the intensive care unit stay (p<0.001) was significantly longer in the infection group compared to the control group.
Conclusions:
Based on our results, we uncovered independent relationships between the conversion of colonization to infection regarding positive S. aureus and bloodstream results, as well as significant differences between the two groups regarding postoperative C-reactive protein levels and white blood cell counts.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin create...