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Invasive Bacterial and Fungal Infections After Pediatric Cardiac Surgery: A Single-center Experience

Gian Maria Tönz1, Alexander Kadner2, Jean-Pierre Pfammatter1,3

  • 1From the Department of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

The Pediatric Infectious Disease Journal
|November 24, 2020
PubMed

Insights

Postoperative infections in pediatric cardiac surgery patients occurred at a 7% rate. High surgical complexity and longer pediatric intensive care unit (PICU) stays were identified as key risk factors for these infections.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Distinguishing infectious from non-infectious complications in pediatric cardiac surgery patients with inflammatory signs is difficult.
  • Low prevalence of infections post-heart surgery may lead to overuse of antibiotics.
  • This study aimed to assess infection rates and management strategies.

Purpose of the Study:

  • Determine the incidence of invasive bacterial or fungal infections in children after cardiac surgery.
  • Evaluate current postoperative management practices for these infections.
  • Identify risk factors associated with postoperative infections.

Main Methods:

  • Single-center retrospective observational cohort study.
  • Included children aged 16 or younger undergoing cardiac surgery between January 2012 and December 2015.
  • Analyzed 395 surgical procedures.

Main Results:

  • Thirty-five postoperative invasive bacterial or fungal infections were identified in 29 episodes (7% incidence).
  • Bacteremia and pneumonia were the most common infection sites.
  • Infections were associated with higher surgical complexity scores and longer pediatric intensive care unit (PICU) stays.
  • Antibiotics were continued for over 3 days in 43% and over 5 days in 22% of cases without documented infection.

Conclusions:

  • The rate of postoperative bacterial or fungal infection is comparable to existing literature.
  • High surgical complexity and prolonged PICU stay are significant risk factors for infection.
  • Findings suggest potential for optimizing antibiotic stewardship in this patient group.
Abstract

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