Colonization of multidrug resistant pathogens in a hybrid pediatric cardiac surgery center.
BACKGROUND
The incidence of multidrug resistant microorganisms worldwide is increasing. The aim of the study was to present institutional experience with the multidrug resistant microorganism colonization patterns observed in children with congenital heart diseases hospitalized in a hybrid pediatric cardiac surgery center.


METHODS
Microbiological samples were routinely collected in all children admitted to our department. All microbiological samples were analyzed with regard to multidrug resistant microorganisms: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), Gram-negative rods producing extended-spectrum beta-lactamases (ESBL), multidrug resistant Gram-negative rods (MDR-GNRs), carbapenemase-producing Klebsiella pneumoniae (KPC), carbapenem-resistant Acinetobacter baumannii (CRAB) and Pseudomonas aeruginosa (CRPA).


RESULTS
In 30 (9%) swabs 'alert' pathogens from the above group of listed microorganisms were found. All positive swabs were isolated in 19 (16.1%) children. Multidrug resistant pathogen colonization was statistically significantly more often observed in children admitted from other medical facilities than in children admitted from home (38% vs. 10%, p = 0.0089). In the group of children younger than 6 months 'alert' pathogen were more often observed than in older children (34.1% vs. 5.4%, p < 0.001).


CONCLUSIONS
Preoperative multidrug resistant pathogen screening in children admitted and referred for congenital heart disease procedures may be of great importance since many of these patients are colonized with resistant bacteria. Knowledge of the patient's microbiome is important in local epidemiological control along with tailoring the most effective preoperative prophylactic antibiotic for each patient. The impact of preoperative screening on postoperative infections and other complications requires further analysis.
Department of Pediatric Cardiac Surgery, Copernicus Hospital, Gdansk, Poland.
Radoslaw
R
Jaworski
Department of Pediatric Cardiac Surgery, Copernicus Hospital, Gdansk, Poland; Chair of Physiotherapy, Gdansk University of Physical Education and Sport, Gdansk, Poland.
Ireneusz
I
Haponiuk
Department of Pediatric Cardiac Surgery, Copernicus Hospital, Gdansk, Poland.
Mariusz
M
Steffens
Department of Microbiology, Medical Laboratories Bruss, Gdynia, Poland.
Elzbieta
E
Arlukowicz
Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland.
Ninela
N
Irga-Jaworska
Department of Pediatric Cardiac Surgery, Copernicus Hospital, Gdansk, Poland.
Maciej
M
Chojnicki
Department of Pediatric Cardiac Surgery, Copernicus Hospital, Gdansk, Poland.
Ewelina
E
Kwasniak
Department of Surgical Oncology, Medical University of Gdansk, Gdansk, Poland.
Jacek
J
Zielinski
alert pathogen colonization; cardiac surgery; congenital heart defects; surgical infections