Alten JA, et al. - In the present study, the researchers intended to characterize the epidemiology of healthcare-associated infections (HAIs) across the entire spectrum of patients (surgical and nonsurgical) receiving care in dedicated pediatric cardiac intensive care units (CICUs). They provided comprehensive multicenter benchmark data regarding rates of HAIs within dedicated pediatric CICUs. Although rare, HAIs of all types were correlated with significant resource utilization and mortality.

Methods

• Researchers performed a retrospective analyses of 22,839 CICU encounters from October 2013 to September 2016 across 22 North American CICUs contributing data to the Pediatric Cardiac Critical Care Consortium clinical registry.

Results

• The study results showed that HAIs occurred in 2.4% of CICU encounters at a rate of 3.3 HAIs/1000 CICU days, with 73% of HAIs occurring in children <1 year.
• It was observed that 80 encounters (14%) had ≥2 HAIs.
• Researchers found that aggregate rates for the 4 primary HAIs were as follows: central line–associated blood stream infection, 1.1/1000 line days; catheter-associated urinary tract infections, 1.5/1000 catheter days; ventilator-associated pneumonia, 1.9/1000 ventilator days; surgical site infections, 0.81/100 operations.
• Similar HAIs rates/1000 CICU days were found in surgical and nonsurgical patients.
• Incidence was twice as high in surgical encounters and increased with surgical complexity.
• Data reported that postoperative infection occurred in 2.8% of encounters.
• They discovered that prematurity, younger age, presence of congenital anomaly, Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Mortality Categories (STAT) 4–5 surgery, admission with an active medical condition, open sternum and extracorporeal membrane oxygenation were independently correlated with HAIs.
• HAI was correlated with longer hospital length of stay and durations of urinary catheter, central venous catheter and ventilation in univariable analysis.
• According to the findings obtained, mortality was 24.4% in patients with HAIs vs 3.4% in those without, P < 0.0001.