Nosocomial pneumonia risk factors and Endotracheal aspirate cultures in its prediction: results of a pediatric cardiovascular surgery intensive care unit of a tertiary center in Turkey

Hospital acquired infections, nosocomial pneumonia(NP) being the second most common, is the major cause of morbidity and mortality in children undergoing cardiovascular surgeries. In this retrospective study, the data of 875 children, 1/12 to 16 years of age, who underwent cardiovascular surgery between January,2014-February,2016 in Kartal Koşuyolu Research and Training Hospital were detected. 281(168 males, 113 females) of them, mechanically ventilated longer than 3 days postoperatively, were included in the study. NP was diagnosed in 41 of them (14.5%) according to the Center for Disease Control(CDC) criteria. ETA cultures were obtained regularly. The isolated pathogens were Klebsiella Pneumonia(29.2%), Pseudomonas Aeruginosa(24.3%), Stenotrophomonas Maltophilia(21.9%), Acinetobacter Baumannii(17.3%) and Candida Albicans(7.3%). The overall mortality was 28.8%(81/281) and the mortality due to NP was 14.8%(12/81). There was a statistically significant relationship between the age, duration of mechanic ventilation, reintubation and NP. (p<0.05) However, the correlation between the gender, use of antacids, accompanying abnormalities, nasogastric feeding and the ETA positivity was nonsignificant. (p>0.05) Assessment of responsible pathogens via routine ETA cultures and determining the risk factors of NP will help us promote our infection control measures to decrease the postoperative morbidity and mortality rates. Moreover, these findings may form a base for further studies in other pediatric cardiovascular surgery intensive care units(PCVS-ICU).