Nosocomial infections after pediatric cardiac surgery

Sarvikivi, Emmi; Lyytikäinen, Outi; Nieminen, Heta; Sairanen, Heikki; Saxén, Harri

doi:10.1016/j.ajic.2007.11.006

Cited by 42 publications

(50 citation statements)

References 19 publications

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“…25) In this study, procedures with a high ABC score were a significant factor for postoperative mediastinitis (p = 0.04), and the incidence of mediastinitis also tended to increase for procedures with a high RACHS-1 score (p = 0.06). Sarvikivi, et al indicated that procedures with high American Society of Anesthesiologists (ASA) score, 26) and high RACHS-1 score were SSI risk factors, stating that highly complex surgical procedures were risk factors for SSIs, 12) a result that agrees with our own observations. Numerous studies in cardiac surgery have shown that operation time is a risk factor for SSIs.…”

Section: Discussionsupporting

confidence: 83%

“…Numerous studies in cardiac surgery have shown that operation time is a risk factor for SSIs. 8,9,12,13) This supports the results in this study. Low body temperature during surgery was also found to be a risk factor for SSIs by McAnally, et al 27) Our results also showed that lowest rectal temperature was a significant factor affecting mediastinitis.…”

Section: Discussionsupporting

confidence: 82%

“…Some of the preoperative factors that are generally believed to affect SSIs include newborns aged <1 month, infants aged <1 year, duration of preoperative hospitalization ≥48 h, and genetic syndromes. 8,12,14,15) In terms of the preoperative attributes of the patients in this study, patients in Group R were younger than those in Group E, with significantly lower height, weight and body surface area (Table 1). Despite this, the occurrence of SSIs and mediastinitis was reduced in Group R. This indicates that the efficacy of our SSI prevention measures outweighed the disadvantage of small body size.…”

Section: Discussionmentioning

confidence: 99%

“…3,[8][9][10][11][12][13] At our hospital, because we experienced an outbreak of SSIs caused by MRSA, the incidence of SSIs prior to the introduction of SSI prevention measures was remarkably high, at 17.0%, and mediastinitis accounted for 70% of cases. SSI prevention measures were therefore an urgent issue, and we collaband the degree of each procedure difficulty in congenital heart surgery.…”

Section: Discussionmentioning

confidence: 99%

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Nasal Methicillin-Resistant S. Aureus is a Major Risk for Mediastinitis in Pediatric Cardiac Surgery

Katayanagi

2015

ATCS

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Background: Mediastinitis caused by methicillin-resistant Staphylococcus aureus (MRSA)is a serious complication after pediatric cardiac surgery. An outbreak of surgical site infections (SSIs) provided the motivation to implement SSI prevention measures in our institution. Methods: Subjects comprised 174 pediatric patients who underwent open-heart surgery after undergoing preoperative nasal culture screening. The incidence of SSIs and mediastinitis was compared between an early group, who underwent surgery before SSI measures (Group E, n = 73), and a recent group, who underwent surgery after these measures (Group R, n = 101), and factors contributing to the occurrence of mediastinitis were investigated. Results: The incidence of both SSIs and Mediastinitis has significantly decreased after SSI measures. With regard to factors that significantly affected mediastinitis, preoperative factors were "duration of preoperative hospitalization" and "preoperative MRSA colonization," intraoperative factors were "Aristotle basic complexity score," "operation time," "cardiopulmonary bypass circuit volume" and "lowest rectal temperature." And postoperative factor was "blood transfusion volume." Patients whose preoperative nasal cultures were MRSA-positive suggested higher risk of MRSA mediastinitis. Conclusions: SSI prevention measures significantly reduced the occurrence of SSIs and mediastinitis. Preoperative MRSA colonization should be a serious risk factor for mediastinitis following pediatric cardiac surgeries.

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Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Nasal Methicillin-Resistant S. Aureus is a Major Risk for Mediastinitis in Pediatric Cardiac Surgery

Katayanagi

2015

ATCS

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“…Se han reportado incidencias que van de 16 a 31%, más alta que la observada en los pacientes hospitalizados en unidades de cuidados intensivos pediátricos general. Está ampliamente reportada su asociación con aumento en los días de hospitalización, costos asociados a la intervención, uso de antimicrobianos y riesgo de mortalidad [1][2][3][4][5][6][7][8] . Los tipos más comunes de IAAS reportadas en pacientes pediátricos post operados de cirugía cardíaca son las infecciones del sitio quirúrgico y del torrente sanguíneo.…”

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