59. Urinary tract infection in children after cardiac surgery: Incidence, risk factors and outcome

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• 作者：Rehana Shafi ; Anis Fatima ; Julinar Idris ; Akhter Mehmood ; Sameh Ismail ; Omar Hijazi ; Mohamed Kabbani ; Reetam Singh ; Huthaim Al Muhaidib
• 刊名：Journal of the Saudi Heart Association
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：27
• 期：4
• 页码：322
• 全文大小：44 K

文摘

Urinary tract infection (UTI) can prolong hospitalization, and increase morbidity. Catheter associated UTI (CAUTI) is a major cause of UTI. The aim of this study is to determine the incidence, risk factors, etiology and outcome of UTI in postoperative cardiac children.

Methods

This is retrospective cohort study. All post-operative patients admitted to PCICU during 2012 were included. Patients were divided into: group (1) Patients who developed and group (2) patients who did not develop UTI. The two groups were compared for demographic and other variable predictors for UTI.

Results

413 post-cardiac surgical children were included. Group 1 had 29 patients (7%) all had CAUTI. Foley catheter utilization ratio was 44%. CAUTI density rate was 18 per 1000 catheter days. Logistic regression analysis demonstrated that risk factors for developing UTI were: duration of Foley (P < 0.002), associated syndrome (P = 0.01) and prolonged PCICU and hospital stay (P < 0.05). Gram-negative were responsible for 63% and Candida for (24%) of the CAUTI. ESBL caused 30% and MDRO caused 10% of our patients CAUTI.

Conclusions

Foley catheter duration, presence of syndrome and prolonged PCICU and hospital stay were the main risk factors for CAUTI in postoperative pediatric cardiac patients. Resistant Gram-negative were the main cause for BSI with one third of CAUTI cases caused by MDRO or ESBL organisms. The cases with CAUTI were generally sicker and with more morbidity. The study will establish a baseline clinical indicator for monitoring quality improvement and the future measures to minimize CAUTI incidence, and its co-morbidity.