Healthcare-associated infections after pediatric cardiac surgery: a four-year survey

Resumo

Objective. To describe healthcare associated-infections types after pediatric cardiac surgery in a center of a middle-income country

Design. An observational descriptive study

Setting. Pediatric intensive care unit (PICU) of Centro Pediátrico da Lagoa, a tertiary private hospital in Rio de Janeiro, Brazil

Methods. All children submitted to cardiac surgery (CS) were followed until 30 days after procedure. During this period, all HAI were described and compared with other patients admitted in the same period.

Results. Between May 2012 and December 2015, we identified 27 (15.6%) HAI in 173 patients submitted to CS, totalizing  3063 patients-days. Density of incidence (per 1000 patients/days) of all HAI was 8.8 in the study group and 11.1 in patients not submitted to cardiac surgery. Of all HAI, we diagnosed 11 surgical site infections (SSI), 6 central-line bloodstream infections (CLABSI), 5 clinical sepsis, 2 ventilator-associated pneumonia (VAP), 1 catheter-associated urinary tract infection (CAUTI) and 1 vascular infection and cutaneous infection. SSI represented 40.7% of all cases of HAI. Media time to acquisition of SSI were 6.3 days and 15.2 days for CLABSI (p=0.0083). In 17 cases, HAIs were defined by clinical criteria, without etiological agent identification. A Gram-negative bacteria was identified in 4 cases, a Gram-positive bacteria in other 4 cases, a yeast in one and, in the last case we found 2 bacteria (both Gram-positive) causing HAI.

Conclusion: SSI was the most common type of HAI, but rates of infections after surgery were similar to other patients admitted in PICU during the same period.