Catheter-associated bloodstream infection incidence and outcomes in congenital cardiac surgery.

Abstract

Catheter-associated bloodstream infections complicate and prolong hospitalizations. The incidence of catheter-associated bloodstream infections in children undergoing congenital cardiac surgery has not been reported. This study sought to define the incidence of catheter-associated bloodstream infections after congenital cardiac surgery in neonates and infants ≤12 months old and compare hospital outcomes and costs to those who underwent surgery and did not have a catheter-associated bloodstream infections. Retrospective review of hospital admissions between October 2013 and November 2015 for neonates and infants ≤12 months old at admission with ICD-9 codes for congenital cardiac surgery from discharge data from Vizient Clinical Data Base/Resource Manager (formerly University HealthSystem Consortium), an analytic platform for performance improvement. Hospitals were included if they had >100 congenital cardiac surgery admissions during the study period. Admissions were stratified by age at admission: Neonates (<1 month) and Infants (1-12 months). Established database flags for catheter-associated bloodstream infections were utilized. Length of stay, mortality, and direct costs were compared between admissions with and without catheter-associated bloodstream infections using t test or χ2 , as appropriate. Catheter-associated bloodstream infections incidence after congenital cardiac surgery was higher in Neonates than Infants (1.5 vs 0.8%, P = .024). Length of stay and direct costs were significantly higher for patients with catheter-associated bloodstream infections in both groups. Mortality was higher in the Infant group with catheter-associated bloodstream infections compared to those without catheter-associated bloodstream infections. Neonates develop catheter-associated bloodstream infections at nearly twice the rate of older infants. For those who develop infection, mortality is 2-8-fold greater and hospital costs are 4-6-fold higher, which further highlight the importance of catheter-associated bloodstream infections prevention in this population.