title: Impact of the implementation of an interdisciplinary infection control program to prevent surgical wound infection in pediatric heart surgery.
abstract: Surgical site infection (SSI) remains a major source of morbidity, mortality, and increased health care costs in children undergoing heart surgery. The aim of this study was to assess the effectiveness of an intervention program designed to reduce the high incidence of SSI observed at our center in pediatric patients. An interdisciplinary infection control program including pre-, intra-, and postoperative measures was introduced for children undergoing heart surgery with cardiopulmonary bypass. We conducted a quasi-experimental interventional study comparing a pre-intervention cohort (June 2009 to March 2010) and a post-intervention cohort (July 2011 to July 2012). A significant drop in SSI incidence from 10.9 % (95 % CI 4.7-18.8) to 1.92 % (95 % CI 0.4-5.52) was observed. Variables significantly associated with infection risk were median age (14 days in infected vs 2.3 years in non-infected patients; p<0.01), hospitalization unit (10.3 % SSI cumulative incidence in the neonatal intensive care unit vs 0 cases in the pediatric intensive care unit; p<0.01), and median preoperative hospital stay (14 days in infected vs 1 day in non-infected patients; p=0.03).
  
  
  CONCLUSIONS
  The implementation of a new intervention program was associated with an 82 % (95 % CI 34-94) reduction in SSI incidence in children undergoing heart surgery at our center.
  
  
  BACKGROUND
  • Surgical site infection (SSI) is associated with significant morbidity and mortality following pediatric cardiac surgery. • Younger patients and longer cardiopulmonary bypass times are associated with higher SSI rates. What is New: • Comprehensive infection control program including preoperative, intraoperative and postoperative nonpharmacologic measures is a key factor for the prevention of SSI. • A significant reduction in SSI rates can be achieve despite a narrower-spectrum antibiotic usage.
authors: Department of Pediatric Intensive Care Medicine, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: Jaume
authors: J
authors: Izquierdo-Blasco
authors: Magda
authors: M
authors: Campins-Martí
authors: Pere
authors: P
authors: Soler-Palacín
authors: Joan
authors: J
authors: Balcells
authors: Raul
authors: R
authors: Abella
authors: Ferran
authors: F
authors: Gran
authors: Félix
authors: F
authors: Castillo
authors: Rosario
authors: R
authors: Nuño
authors: Joan
authors: J
authors: Sanchez-de-Toledo
mesh_terms: D000367:Age Factors; D002315:Cardiopulmonary Bypass; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control; D007363:Intensive Care Units, Neonatal; D015278:Intensive Care Units, Pediatric; D008297:Male; D010348:Patient Care Team; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D056346:Sternotomy; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*
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