Parenteral Nutrition Is One of the Most Significant Risk Factors for Nosocomial Infections in a Pediatric Cardiac Intensive Care Unit

Roberta Netto, Matteo Mondini, Chiara Pezzella, Lorenza Romani, Barbara Lucignano, Laura Pansani, Patrizia D'Argenio, Paola Cogo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Nosocomial infections (NIs) are associated with significant morbidity and mortality and increased healthcare costs. We aimed to assess the NI epidemiology and associated risk factors in a pediatric cardiac intensive care unit (PCICU). Materials and Methods: Prospective observational study on 1106 patients admitted to a PCICU from January 1, 2012, to October 31, 2013. NIs were defined and recorded weekly by a multidisciplinary team. Independent risk factors for NIs were assessed by logistic regression analysis in the overall cohort, in cardiac surgical patients, and in those who had cardiopulmonary bypass (CPB). Results: Ninety-two patients (8.3%) had NIs. Overall mortality was 2% but 8.3% in children with NIs (P <.001). The most frequent NIs were pneumonia (19.6%), bacteremia of unknown origin (16.3%), and catheter-associated bloodstream infection (14.1%) caused mainly by Staphylococcus aureus and Pseudomonas aeruginosa. In the overall cohort, independent risk factors for NIs were number of days of parenteral nutrition (PN), days of invasive and noninvasive ventilation, ward before PCICU admission, and days of PCICU stay; in the cardiac surgical patients, the risk factors were days of PN and days of invasive and noninvasive ventilation; in children who had undergone CPB, the risk factors for NIs were days of PN, delayed sternal closure, reintervention, length of CPB, younger age, and days of invasive ventilation. Conclusion: Mortality was significantly higher in patients with NIs. The use of PN was one of the most significant predictors for NIs in the overall cohort of PCICU patients, cardiac surgical patients, and those who required CPB.

Original languageEnglish
Pages (from-to)612-618
Number of pages7
JournalJournal of Parenteral and Enteral Nutrition
Volume41
Issue number4
DOIs
Publication statusPublished - May 1 2017

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Pediatric Intensive Care Units
Parenteral Nutrition
Cross Infection
Cardiopulmonary Bypass
Noninvasive Ventilation
Mortality
Catheter-Related Infections
Bacteremia
Health Care Costs
Pseudomonas aeruginosa
Observational Studies
Ventilation
Staphylococcus aureus
Pneumonia
Epidemiology
Logistic Models
Regression Analysis
Prospective Studies

Keywords

  • catheter
  • congenital heart defect
  • intensive care unit
  • nosocomial infection
  • parenteral nutrition
  • risk

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Parenteral Nutrition Is One of the Most Significant Risk Factors for Nosocomial Infections in a Pediatric Cardiac Intensive Care Unit. / Netto, Roberta; Mondini, Matteo; Pezzella, Chiara; Romani, Lorenza; Lucignano, Barbara; Pansani, Laura; D'Argenio, Patrizia; Cogo, Paola.

In: Journal of Parenteral and Enteral Nutrition, Vol. 41, No. 4, 01.05.2017, p. 612-618.

Research output: Contribution to journalArticle

Netto, Roberta ; Mondini, Matteo ; Pezzella, Chiara ; Romani, Lorenza ; Lucignano, Barbara ; Pansani, Laura ; D'Argenio, Patrizia ; Cogo, Paola. / Parenteral Nutrition Is One of the Most Significant Risk Factors for Nosocomial Infections in a Pediatric Cardiac Intensive Care Unit. In: Journal of Parenteral and Enteral Nutrition. 2017 ; Vol. 41, No. 4. pp. 612-618.
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AU - Netto, Roberta

AU - Mondini, Matteo

AU - Pezzella, Chiara

AU - Romani, Lorenza

AU - Lucignano, Barbara

AU - Pansani, Laura

AU - D'Argenio, Patrizia

AU - Cogo, Paola

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N2 - Background: Nosocomial infections (NIs) are associated with significant morbidity and mortality and increased healthcare costs. We aimed to assess the NI epidemiology and associated risk factors in a pediatric cardiac intensive care unit (PCICU). Materials and Methods: Prospective observational study on 1106 patients admitted to a PCICU from January 1, 2012, to October 31, 2013. NIs were defined and recorded weekly by a multidisciplinary team. Independent risk factors for NIs were assessed by logistic regression analysis in the overall cohort, in cardiac surgical patients, and in those who had cardiopulmonary bypass (CPB). Results: Ninety-two patients (8.3%) had NIs. Overall mortality was 2% but 8.3% in children with NIs (P <.001). The most frequent NIs were pneumonia (19.6%), bacteremia of unknown origin (16.3%), and catheter-associated bloodstream infection (14.1%) caused mainly by Staphylococcus aureus and Pseudomonas aeruginosa. In the overall cohort, independent risk factors for NIs were number of days of parenteral nutrition (PN), days of invasive and noninvasive ventilation, ward before PCICU admission, and days of PCICU stay; in the cardiac surgical patients, the risk factors were days of PN and days of invasive and noninvasive ventilation; in children who had undergone CPB, the risk factors for NIs were days of PN, delayed sternal closure, reintervention, length of CPB, younger age, and days of invasive ventilation. Conclusion: Mortality was significantly higher in patients with NIs. The use of PN was one of the most significant predictors for NIs in the overall cohort of PCICU patients, cardiac surgical patients, and those who required CPB.

AB - Background: Nosocomial infections (NIs) are associated with significant morbidity and mortality and increased healthcare costs. We aimed to assess the NI epidemiology and associated risk factors in a pediatric cardiac intensive care unit (PCICU). Materials and Methods: Prospective observational study on 1106 patients admitted to a PCICU from January 1, 2012, to October 31, 2013. NIs were defined and recorded weekly by a multidisciplinary team. Independent risk factors for NIs were assessed by logistic regression analysis in the overall cohort, in cardiac surgical patients, and in those who had cardiopulmonary bypass (CPB). Results: Ninety-two patients (8.3%) had NIs. Overall mortality was 2% but 8.3% in children with NIs (P <.001). The most frequent NIs were pneumonia (19.6%), bacteremia of unknown origin (16.3%), and catheter-associated bloodstream infection (14.1%) caused mainly by Staphylococcus aureus and Pseudomonas aeruginosa. In the overall cohort, independent risk factors for NIs were number of days of parenteral nutrition (PN), days of invasive and noninvasive ventilation, ward before PCICU admission, and days of PCICU stay; in the cardiac surgical patients, the risk factors were days of PN and days of invasive and noninvasive ventilation; in children who had undergone CPB, the risk factors for NIs were days of PN, delayed sternal closure, reintervention, length of CPB, younger age, and days of invasive ventilation. Conclusion: Mortality was significantly higher in patients with NIs. The use of PN was one of the most significant predictors for NIs in the overall cohort of PCICU patients, cardiac surgical patients, and those who required CPB.

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KW - congenital heart defect

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KW - parenteral nutrition

KW - risk

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