PURPOSE: This investigation was conducted to describe the epidemiology, incidence, risk factors and outcome of nosocomial pneumonia in post cardiac surgery patients.
METHODS: A retrospective cohort study of patients admitted at the pediatric cardiovacular surgical ICU age 18 years old and below, who developed nosocomial pneumonia after cardiac surgery from January 2003 to June 2004 were reviewed.
RESULTS: A total of 608 patients underwent cardiac surgery, of which 360 patients underwent open heart surgery and 248 underwent closed heart surgery. Among these, 27 patients developed nosocomial pneumonia with the incidence of 4.4%. Independent predictors of pneumonia were: intubated state, feeding through NGT/OGT, previous antibiotic use, use of sedatives and H2 receptor antagonist. A total of 37 pathogenic microbial strains were isolated. Gram negative were the most frequent isolates (33 isolates,89.18%).The most common etiologic organisms is Stenotrophomonas maltophilia (11 isolates,29.72%).
CONCLUSION: Gram negative bacilli remains the most common pathogen isolated in our study. Risk factors in the development of nosocomial pneumonia include intubated state, feeding through the NGT/OGT, previous antibiotic use and use of sedatives and H2 receptor antagonist.It is important to recognize the predominant pathogen associated with nosocomial pneumonia since infections may vary between hospitals as well as between specialized units within same hospital.
CLINICAL IMPLICATIONS: The findings of the study would recommend to adopt multidisciplinary approach in the implementation and devlopment of strategies to reduce overall infection in the pediatric ICU.
DISCLOSURE: Alfredo Bongo, None.