Risk factors for surgical site infections after pediatric cardiovascular surgery

Allpress, Amanda L.; Rosenthal, Geoffrey L.; Goodrich, Kathy M; Lupinetti, Flavian M.; Zerr, Danielle M.

doi:10.1097/01.inf.0000114904.21616.ba

Cited by 100 publications

(99 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar results have been reported previously in adult patients with cardiothoracic operations [114]. [20] 1580 (1580)…”

Section: Surgical Site Infectionssupporting

confidence: 80%

“…Most earlier studies have reported the finding that preoperative hospitalization for more than two days increased the risk for SSI [20,22,23]; only one of them reported no association [21]. The duration of surgery or perfusion time [20][21][22] and having an open chest after the operation [23,24] were identified as risk factors for infection in earlier studies, but we found no such association.…”

Section: Risk Factors For Surgical Site Infectionscontrasting

confidence: 49%

“…In adults undergoing coronary artery bypass surgery, SSIs reportedly occur after 8%-10% of procedures [18,19], and a considerable proportion of these infections was reportedly detected after discharge. Pediatric studies on open-heart surgery patients to date have reported lower SSI rates [20][21][22][23], suggesting that other types of HAI predominate in these patients [22][23][24]. However, none of these studies had conducted postdischarge surveillance, which may have affected the SSI rates.…”

Section: Introductionmentioning

confidence: 89%

“…The risk factors for SSI in these studies included young (neonatal) age, cyanotic heart disease, a high ASA score, an extended preoperative hospital stay, prolonged duration of surgery, an open chest postoperatively, and extended mechanical ventilation [20][21][22][23][24]. However, the widely used NNIS risk index score, which stratifies patients according to three risk factors (an ASA score ≥3, a wound contamination classification of either contaminated or dirty, and a duration of operation longer than the 75 th percentile of the duration for each operative procedure) [110,111] did not seem to adequately stratify pediatric cardiac surgery patients [112,113].…”

Section: Surgical Site Infectionsmentioning

confidence: 99%

“…CVC data was available for 580 (83%) primary BSIs and 75% of those were CVC-associated. In total, 27,279 blood samples were obtained for culture (median 62; range by year, 48-91 cultures per 1,000 patientdays), and 27 BSIs were confirmed per 1,000 blood cultures (range by year, [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36].…”

Section: Characteristics Of Patients With Bloodstream Infectionsmentioning

confidence: 99%

See 4 more Smart Citations

314 Healthcare-Associated Infections in Pediatrics

SpringerReference

View full text Add to dashboard Cite

Helsinki 2008 P u b l i c a t i o n s o f t h e N a t i o n a l P u b l i c H e a l t h I n s t i t u t e K T L A 1 1 / 2 0 0 8 Dr. Alexander Langmuir, 1963 Emmi Sarvikivi, Healthcare-associated infections in pediatrics Publications of the National Public Health Institute, A11/2008, 93 Pages ISBN 978-951-740-803-5; 978-951-740-804-2 (pdf-version) ISSN 0359-3584; 1458-6290 (pdf-version) http://www.ktl.fi/portal/4043 ABSTRACT Background and aims. Healthcare-associated infections (HAIs) are known to increase the risk for patient morbidity and mortality in different healthcare settings and thereby to cause additional costs. HAIs typically affect patients with severe underlying conditions, such as patients treated in intensive care units, or patients who have undergone medical procedures, e.g., surgery. HAIs are prevalent also among pediatric patients, but the distribution of the types of infection and the causative agents differ from those detected in adults. The aim of this study was to obtain information on pediatric HAIs in Finland through an assessment of the surveillance of bloodstream infections (BSIs), through two outbreak investigations in a neonatal intensive care unit (NICU), and through a study of postoperative HAIs after open-heart surgery.Methods. The Hospital for Children and Adolescents of the Helsinki University Central Hospital has participated in the BSI surveillance of the Finnish Hospital Infection Program since 1999. These data were utilized in all studies. The epidemiological features of pediatric BSIs were assessed. For the outbreak investigations, case definitions were set and data collected from microbiological and clinical records. The antimicrobial susceptibilities of the Serratia marcescens and the Candida parapsilosis isolates were determined. The S. marcescens isolates were genotyped with pulsed-field gel electrophoresis and the C. parapsilosis blood culture isolates (obtained between the years 1990 and 2002) with Southern blot hybridization by use of a DNA fingerprinting probe. Patient charts were reviewed for the case-control and cohort studies during the outbreak investigations, as well as for those patients who acquired surgical site infections (SSIs) after having undergone open-heart surgery. Also a prospective postdischarge study was conducted to detect postoperative HAIs after open-heart surgery.Results. During 1999During -2006, the overall annual BSI rate was 1.6/1,000 patient-days (range by year, 1.2-2.1). High rates (average, 4.9 and 3.2 BSIs/1,000 patient-days) were detected in hematology and neonatology units. Coagulase-negative staphylococci were the most common pathogens both hospital-wide and in each patient group. The overall mortality was 5%. The genotyping of the 15 S. marcescens isolates revealed three independent clusters. All of the 26 C. parapsilosis isolates studied proved to be indistinguishable. No common source was identified for either of the outbreaks, but the NICU was overcrowded during the S. marcescens clusters. In both investigations, low birth we...

show abstract

“…Similar results have been reported previously in adult patients with cardiothoracic operations [114]. [20] 1580 (1580)…”

Section: Surgical Site Infectionssupporting

confidence: 80%

Section: Risk Factors For Surgical Site Infectionscontrasting

confidence: 49%

Section: Introductionmentioning

confidence: 89%

Section: Surgical Site Infectionsmentioning

confidence: 99%

Section: Characteristics Of Patients With Bloodstream Infectionsmentioning

confidence: 99%

See 3 more Smart Citations

314 Healthcare-Associated Infections in Pediatrics

SpringerReference

View full text Add to dashboard Cite

show abstract

Intensive cardiac management in patients with trisomy 13 or trisomy 18

Kaneko

Kobayashi

Yamamoto

et al. 2008

American J of Med Genetics Pt A

112

115

View full text Add to dashboard Cite

KEYWORDS trisomy 13 • trisomy 18 • neonate • congenital heart defects • neonatal intensive care • cardiac surgery ABSTRACTIntensive cardiac management such as pharmacological intervention for ductal patency (indomethacin and/or mefenamic acid for closure and prostaglandin E1 for maintenance) and palliative or corrective surgery is a standard treatment for congenital heart defects. However, whether it would be a treatment option for children with trisomy 13 or trisomy 18 syndrome is controversial because the efficacy on survival in patients with these trisomies has not been evaluated. We retrospectively reviewed 31 consecutive neonates with trisomy 13 or trisomy 18 admitted to our neonatal ward within 6 hr of birth between 2000 and 2005. The institutional management policies differed during three distinct periods. In the first period, both pharmacological ductal intervention and cardiac surgery were withheld. In the second, pharmacological ductal intervention was offered as an option, but cardiac surgery was withheld. Both strategies were available during the third period. The median survival times of 13, 9, and 9 neonates from the first, second, and third periods were 7, 24, and 243 days, respectively. Univariate and multivariate analyses confirmed that the patients in the third period survived significantly longer than the others. Intensive cardiac management consisting of pharmacological intervention for ductal patency and cardiac surgery was demonstrated to improve survival in patients with trisomy 13 or trisomy 18 in this series. Therefore, we suggest that this approach is a treatment option for cardiac lesions associated with these trisomies. These data are helpful for clinicians and families to consider in the optimal treatment of patients with these trisomies.

show abstract

Some parameter characteristics of thermally treated viscose fibers

Fouda¹,

Oraby²,

Seisa³

2010

J of Applied Polymer Sci

View full text Add to dashboard Cite

This article sheds light on some structural changes in thermally treated viscose fibers at a constant temperature of 100 6 1 C at different time periods. The obtained optical parameters were used to calculate the crystallinity, density, Herman's orientation function, average orientation, and form birefringence. In addition, the stress optical coefficients, thermal stress, molar refractivity, specific refractivity, and polarizabilities along and across the axis and segment anisotropy were obtained. Measurements of the refractive indices helped us to calculate the dielectric constant, dielectric susceptibility, surface reflectivity, and transparency transmittances. The mechanisms of structural variation for the viscose fibers due to the annealing process were examined with the structural details for optothermal parameters. The relationships between the measured and calculated parameters are given in illustrations and curves.

show abstract

Risk factors for surgical site infections after pediatric cardiovascular surgery

Abstract: Age <1 month and longer duration of surgery were independently associated with hospitalized SSI after CV surgery in children.

Cited by 100 publications

References 12 publications

314 Healthcare-Associated Infections in Pediatrics

314 Healthcare-Associated Infections in Pediatrics

Intensive cardiac management in patients with trisomy 13 or trisomy 18

Some parameter characteristics of thermally treated viscose fibers

Contact Info

Product

Resources

About