Rafael Quaresma Garrido et al. Cristiane da Cruz Lamas
Infections after pediatric cardiac surgery are important adverse events that can increase morbidity and mortality in these patients. Most studies describe the incidence of infection as between 0.5 and 8%, but some studies in low- to middle-income countries report rates of up to 48%.– The main microorganisms involved are Staphylococcus aureus, coagulase-negative staphylococci, and occasionally hospital-acquired Gram negatives. In high-income countries, there is a predominance of skin-colonizing Gram-positives, while in low- to middle-income countries, there is an increase in the frequency of hospital-acquired Gram-negatives. –
There are divergences between the risk factors for infection in pediatric cardiac surgery, as there are few studies dedicated to this population. In regard to pre-operative conditions or those inherent to the patient, we have as risk factors being a younger child, especially those under 12 months of age, the presence of immunodeficiencies, prolonged periods of pre-operative hospitalization and previous use of antimicrobials (the latter two conditions because they alter the colonizing microbiota) and malnutrition. Pre and post operative risk factors are the inadequacy of antibiotic prophylaxis, breaches of aseptic technique, prolonged cardiopulmonary bypass time (>105 minutes) and aortic clamping time (>85 minutes), excessive bleeding in the first 24 hours, blood transfusion, early chest reexploration due to operative bleeding, occurrence of nosocomial infections (pneumonia and bloodstream infections mainly) and the presence of invasive devices such as drains and pacemaker wires.–
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