Bloodstream infections after median sternotomy at a children's hospital.

Bloodstream infections after median sternotomy at a children's hospital. Research Abstract Details 

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Bloodstream infections after median sternotomy at a children's hospital. Abstract Text:

Samir S Shah,Jessica Kagen,Ebbing Lautenbach,Warren B Bilker,Jennifer Matro,Troy E Dominguez,Sarah Tabbutt,J William Gaynor,Louis M Bell,

OBJECTIVES: Postoperative bloodstream infections are a major source of morbidity and increased health care costs. In adults, mediastinitis has been described as a risk factor for bloodstream infections. The objectives of this retrospective cohort study were to determine the incidence and to identify risk factors for postoperative bloodstream infections among children after median sternotomy in an urban tertiary care children's hospital. METHODS: For this study, 192 patients were randomly selected from among all patients undergoing median sternotomy between January 1, 1995, and December 31, 2003. RESULTS: Ninety-eight (51%) of the 192 eligible patients were male. The median patient age was 5.4 months (interquartile range: 1 day-41.5 years). Bloodstream infections occurred in 12 (6.3%; 95% confidence interval [CI]: 3.3%-10.7%) patients within the first 30 days after median sternotomy. Bloodstream infections developed a median of 11 days (range: 3-29 days) after median sternotomy. Gram-negative bacilli caused 6 (50%) of the 12 bloodstream infections. Specific causes of bloodstream infections included Pseudomonas aeruginosa (n = 3), coagulase-negative staphylococci (n = 3), Pseudomonas fluorescens-putida (n = 2), Staphylococcus aureus (n = 2), Serratia marcescens (n = 1), and Candida albicans (n = 1). Multivariable analysis revealed that the development of mediastinitis (odds ratio [OR], 28.16; 95% CI, 3.37-235.22) and the requirement for postoperative extracorporeal membrane oxygenation (OR, 12.52; 95% CI, 2.99-52.41) were associated with bloodstream infections after median sternotomy. CONCLUSIONS: Postoperative bloodstream infections occurred in 6.3% of children undergoing median sternotomy. Postoperative mediastinitis and the requirement for extracorporeal membrane oxygenation were risk factors for bloodstream infections after median sternotomy. These findings warrant exploration in a larger, multicenter study.

Bloodstream infections after median sternotomy at a children's hospital. Publishing Authors By Initials

SS Shah,J Kagen,E Lautenbach,WB Bilker,J Matro,TE Dominguez,S Tabbutt,JW Gaynor,LM Bell,

For similar surgical procedures, operative: thoracic surgical procedures: thoracotomy research abstracts see: surgical procedures, operative: thoracic surgical procedures: thoracotomy research

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Bloodstream infections after median sternotomy at a children's hospital. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: The Journal of thoracic and cardiovascular surgery

VOLUME: 133

Page Numbers: 435-40

Journal Abbreviation: J. Thorac. Cardiovasc. Surg.

ISSN: 1097-685X

DAY: 3

MONTH: Feb

YEAR: 2007

Bloodstream infections after median sternotomy at a children's hospital. Information

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LANGUAGE: eng

NlmUniqueID: 376343

Bloodstream infections after median sternotomy at a children's hospital. Keywords Mesh Terms:

KEYWORDS: Thoracotomy

MESH TERMS: statistics & numerical data

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Grant and Affiliation Information for Bloodstream infections after median sternotomy at a children's hospital.

AFFILIATION: Division of Infectious Diseases, The Children's Hospital of Philadelphia, Philadelphia, Pa 19104, USA. shahs@email.chop.edu

Country: United States

AGENCY: United States AHRQ

GRANT: HS10399

ACRONYM: HS

MEDLINETA: J Thorac Cardiovasc Surg

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