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Investigation into Pediatric Cardiac Surgery: Infection Prevention, Control and Impact of Multi-Drug Resistant Organisms during the COVID-19 Epidemic

The focus of this study is the profound impact that doing proper Infection Prevention and Control (IPC) practice has on the prognosis following pediatric cardiac surgery, particularly during the COVID-19 pandemic. It attempts to provide surveillance data on the incidence and density of various hospital-associated infections observed in large healthcare facilities. This study also examines how multi-drug resistant organisms (MDRO) might influence the in-hospital prognosis post-congenital heart disease surgery. To achieve these aims, a single-center retrospective research was executed, involving pediatric patients who had undergone cardiac surgery in the years 2021 and 2022. The researchers carried out an assessment of postoperative bacterial and fungal cultures, as well as their antimicrobial stewardship.

A total of 4776 patients were involved in this study. Out of these, the analysis of postoperative cultures revealed that 101 patients developed infections, corresponding to a nosocomial infection rate of 2.1%. There were 40 MDRO specimens obtained from 36 patients, 50 non-MDRO specimens from 30 patients, and 11 fungal specimens from 10 individuals. The incidence of pneumonia stood at 1.5%, with a reported ventilator-associated pneumonia incidence density of 7.2 per 1000 patient-days. The occurrence of sepsis was recorded at 0.4%, with an incidence density of catheter-related bloodstream infection of 0.24 per 1000 patient-days, and surgical site infection was 0.06%. The IPC performance of Fuwai Hospital, Beijing, achieved satisfactory results during the study period; however, it was noted that MDRO infection can lead to a longer intensive care unit stay.

The primary objective of the research was to gather comprehensive data related to infection surveillance and identify potential areas for further improvement in the National Center for Cardiovascular Diseases in China (Fuwai Hospital). This center-specific retrospective cohort study included pediatric patients, aged up to 14 years, who underwent cardiac surgery at Fuwai Hospital between 2021 and 2022. Patients undergoing medical therapy, interventional therapy, or surgical therapy in other centers within Fuwai Hospital were excluded from this study.

Finally, the research pointed out that the Fuwai Hospital achieved satisfactory results in infection prevention and control. However, given the diversity of medical conditions across regions in China, a populous developing nation, prospective, multicenter, observational studies should be pursued for future research. The study thus implies an urgent need for substantial global attention to the IPC efforts in developing countries and proposes execution of comprehensive infection surveillance for more accurate and efficient patient care.


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