Evaluation of Properties, Pathogens, and Mortality-Related Risk Factors of Nosocomial Infections in Pediatric Cardiovascular Surgery Intensive Care Unit

Abstract

Introduction: The aim of this study was to evaluate the properties, pathogens, mortality-related risk factors, and mortality rates of nosocomial infections (NIs) in the pediatric cardiovascular surgery intensive care unit. Patients and Methods: The files of 838 children, aged 0-16 years, who underwent cardiovascular surgery between January, 2014 and January, 2016 in Kartal Koşuyolu Research Hospital were evaluated in this retrospective study. NI was diagnosed according to the Center for Disease Control criteria. The correlations between several risk factors and NI were statistically analyzed. Results: Fifty-four children out of 838 (6.4%) had NI. 29 of them (53.9%) had respiratory tract infections, 14 (24.8%) had urinary tract infections, 8 (15.7%) had bacteremia and 3 (5.6%) had wound site infections. The isolated pathogens were Klebsiella pneumoniae (20.4%), Pseudomonas aeruginosa (18.6%), Candida albicans (18.6%), Stenotrophomonas maltophilia (13.8%), Acinetobacter baumannii (10.5%), coagulase-negative staphylococci (9.1%), methicillin-resistant Staphylococcus aureus (MRSA, 3.6%), Serratia marcescens (1.8%), Citrobacter freundii (1.8%), and Providencia rettgeri (1.8%). The mortality rate due to NI was 13.7% (11/80). There was a statistically significant relationship between NIs and age and duration of mechanic ventilation (p< 0.05), but not between NIs and gender, accompanying abnormalities, and nasogastric feeding (p> 0.05). Conclusion: Gram-negative bacteria were the most common pathogens of NI, which caused mortality. Assessing the responsible pathogens and determining the risk factors will help us to develop effective infection control measures for reducing the morbidity and mortality rates.