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Postoperative nosocomial infections among children with congenital heart disease

Jian Zhang1, Yan Yuan2, Peiling Li3

  • 1Jian Zhang, Pediatric Intensive Care Unit, The First Affiliated Hospital of Xinxiang Medical University Weihui 453100, P. R. China.

Pakistan Journal of Medical Sciences
|June 21, 2014
PubMed

Insights

Postoperative nosocomial infections are common in pediatric congenital heart disease patients. Gram-positive bacteria, often resistant to common antibiotics, drive these infections, highlighting the need to manage risk factors.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Healthcare-Associated Infections

Background:

  • Congenital heart disease (CHD) in children presents unique challenges, including increased susceptibility to postoperative complications.
  • Nosocomial infections (NIs) represent a significant threat to the recovery and outcomes of pediatric patients undergoing cardiac surgery.
  • Understanding pathogen distribution and antimicrobial resistance is crucial for effective management of NIs in this vulnerable population.

Purpose of the Study:

  • To investigate the spectrum of pathogens causing postoperative nosocomial infections in children with CHD.
  • To determine the antimicrobial susceptibility patterns of these pathogens.
  • To identify independent risk factors associated with the development of nosocomial infections in this patient group.

Main Methods:

  • A retrospective study involving 300 pediatric patients with CHD who underwent surgery between February 2010 and February 2013.
  • Sputum cultures were used to identify causative microorganisms in infected patients.
  • Multivariate logistic regression analysis was employed to identify significant risk factors for nosocomial infections.

Main Results:

  • An overall infection rate of 40.0% was observed, with 120 children testing positive via sputum culture.
  • The most prevalent pathogens were Staphylococcus epidermidis, Staphylococcus aureus, Enterococcus, Pseudomonas aeruginosa, and Candida albicans.
  • Gram-positive bacteria (S. epidermidis, S. aureus, Enterococcus) exhibited high resistance to penicillin, azithromycin, and erythromycin, but remained susceptible to vancomycin. Key risk factors identified included prolonged hospitalization, combined antibiotic use, hormone therapy, mechanical ventilation, and catheter indwelling.

Conclusions:

  • Nosocomial infections are a frequent postoperative complication in pediatric CHD, primarily caused by Gram-positive bacteria.
  • These infections demonstrate high susceptibility to vancomycin and cephalosporins.
  • Mitigating identified risk factors is essential for improving patient prognosis and reducing the incidence of nosocomial infections.
Abstract

Keywords:
Congenital heart diseaseNosocomial infectionRisk factor

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