Hospital acquired infections in postoperative pediatric cardiac surgical ICU

Healthcare-associated infections (HAIs) are infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting [1]. There is a vast body of literature which showing that HAIs are a major cause of patient morbidity and mortality in developed countries [2]. The aim of this study was to determine the rates of HAIs mainly Devic associated Infections (DAIs) and their impact on patient outcome. This study was an open labelled, cohort, prospective study. All admitted cases in the Postoperative Pediatric Cardiac Surgical ICU in Cairo University, Children Hospital, Egypt from 01/01/2009 to 30/12/2010 were included. The study included 175 patients, 88 (50.3%) males, and 87 (49.7%) females. We reported a Ventilator associated Pneumonia (VAP) rate of 73/1000MV days, Catheter-associated Laboratory Confirmed Blood stream infection (CLAB)rate of 18.8/1000CL days, and Catheter associated Urinary tract Infection (CAUTI) of 7/1000UC days. DAIs rates are higher than the Bench marking determined by the International Nosocomial Infection Control Consortium(INICC) using standardized definitions [3]. Fifty four (30.9%) of the studied patients died at the end of the study. HAIs were strongly related to mortality by univariate analysis (p=0.011), but not significantly related to mortality by multivariate analysis (p=0.67). The average extra length of hospital stay due to HAI was 5.4 days. The overall rate of (HH) Hand Hygiene compliance was lower in this study than in the overall INICC PICUs: 47.1% vs 58.6%. In summary, Surveillance of HAIs-defining the magnitude and nature of the problem-is the first step toward reducing the risk of infection in vulnerable hospitalized patients. The next step is to implement targeted basic infection control practices that have been shown to prevent HAIs [2]