title: Risk factors for sternal wound and other infections in pediatric cardiac surgery patients.
abstract: BACKGROUND
  This study was undertaken to determine the incidence, pathogens and risk factors associated with development of sternal wound and other infections in children undergoing cardiac surgery.
  
  
  METHODS
  Retrospective chart review was performed for all cardiac surgeries performed on children <18 years of age at Upstate Medical University at Syracuse between January, 1996, and June, 1998. For evaluation of risk factors for sternal wound infection, only patients undergoing sternotomy are included in the analysis: those with infection are compared with those without for preoperative, intraoperative and postoperative risk factors.
  
  
  RESULTS
  Sternal wound infection developed in 10 of 202 (5%) children after median sternotomy. Superficial sternal wound infection developed in 6 (3%) children, and 4 (2%) had deep infection. Children with sternal wound infection had lower age, higher American Society of Anesthesiologist score, longer preoperative stay, longer period of ventilation and inotropic support, longer intensive care unit and total postoperative hospital stays and increased leukocyte band cell counts preoperatively and on Postoperative Day 1 than those without sternal infection. Causative agents for sternal wound infection were Staphylococcus aureus (6), Pseudomonas aeruginosa (1) and Haemophilus influenzae non-type b (1). In addition 32 bacterial infections occurred at nonsurgical sites after 28 procedures. Infections included pneumonia, urinary tract infection and bacteremia. Longer bypass time and longer operation time were two additional risk factors for nonwound infection.
  
  
  CONCLUSIONS
  Infections continue to be a significant cause of morbidity in cardiac surgery patients. Knowledge of risk factors for infection could be useful in preventive and treatment strategies for these high-risk groups.
authors.affiliation: Department of Pediatrics, State University of New York Upstate Medical University, Syracuse, USA.
authors.forename: P A
authors.initials: PA
authors.lastname: Mehta
authors.forename: C K
authors.initials: CK
authors.lastname: Cunningham
authors.forename: C B
authors.initials: CB
authors.lastname: Colella
authors.forename: G
authors.initials: G
authors.lastname: Alferis
authors.forename: L B
authors.initials: LB
authors.lastname: Weiner
mesh_terms: D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010372:Pediatrics; D018410:Pneumonia, Bacterial / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology; D013903:Thoracic Surgery; D014552:Urinary Tract Infections / Q000453:epidemiology* / Q000382:microbiology