Hospital pneumonia following cardiac surgery in children.
Any massive surgical intervention, especially cardiovascular surgery creates high risk for the development of hospital infections. Hospital pneumonia is the major cause of morbidity and mortality. The aim of our study was to determine the frequency and etiology of hospital pneumonia following cardiac surgery in children and to find out whether the emergency operations and reoperations increase the frequency of hospital pneumonia. We studied 355 patients in Jo Ann Pediatric Cardiac Surgery Clinic, who were operated in the period from January 2002 till December 2004. The age of the patients varied from 1 day to 18 years. Out of 355 operations 290 were primary ones, 65 reoperations. In 320 cases the operations were planed, 35 cases-emergency ones. Out of 355 patients, hospital infection occurred in 42 (11,9%) cases. The most common infectious complication was pneumonia that made up 18 cases (5,1%). In 77,8% of cases pneumonia was associated with mechanical ventilation. Hospital pneumonia in 60% were caused by gram-negative, in 20% -- by gram-positive bacteria and in 20% -- by fungi. The most frequent gram-negative bacterium were nonfermenter gram-negative rods, among these pathogens Stenotrophomonas maltophilia was the most common and the most frequent gram-positive bacterium was Staphylococcus aureus. All three cases of fungal pneumonia were caused by Aspergillus spp. The rate of hospital pneumonia was significantly higher in the cases of emergency operations as well as reoperations.
Jashiashvili
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Georgian State Medical Academy; Jo Ann Pediatric Cardiac Surgery Clinic, Tbilisi, Georgia.
Nanuashvili
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A
D000293:Adolescent; D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006094:Gram-Positive Bacteria / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018410:Pneumonia, Bacterial / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D012307:Risk Factors