Incidence of nosocomial infections in children undergoing cardiac surgery

Children after cardiac surgery treated as inpatients in cardiac pediatric ICUs run an increased risk of nosocomial infection. Hitherto, no comprehensive review of the published literature concerning this topic has been available. A systematic analysis of 23 original papers published in the English literature between 1990 and 2009 was performed covering more than 10 000 pediatric inpatients. The median infection rate (proportion of patients with at least one nosocomial infection) was 15.8% (5.5–30.8%). The nosocomial infection incidence density determined in three studies was 6.8, 6.9, und 21.7 nosocomial infection per 1000 inpatient days. In addition to catheter-associated bloodstream infections (36% of all documented nosocomial infection; 25–66%) surgical site infections play an important role (23%; 8–37% of all documented nosocomial infection). A relevant proportion of all surgical-site infections (SSIs) have been detected after discharge. nosocomial infection prolonged hospital stay and, in some cases, increased the risk of mortality. Due to the heterogeneity of the studies included, our analysis does not provide definite reference data for nosocomial infection in pediatric cardiac surgery patients. Nonetheless, our results may be utilized to assess local nosocomial infection rates, to identify critical control points and to implement preventive intervention programs.