Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis

Daniel J. Lex, Roland Tóth, Zsuzsanna Cserép, Tamás Breuer, Erzsébet Sápi, A. Szatmári, J. Gál, Andrea Székely

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The objective of this study was to identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery.Methods: Following approval from the Institutional Review Board, patient demographics, co-morbidities, surgery details, transfusion requirements, inotropic infusions, laboratory parameters and positive microbial results were recorded during the hospital stay, and the patients were divided into two groups: patients with clinical signs of infection and patients with only positive cultures but without infection during the postoperative period. Using propensity scores, 141 patients with infection were matched to 141 patients with positive microbial cultures but without signs of infection. Our database consisted of 1665 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between the patient group with infection and the group with colonization was analyzed after propensity score matching of the perioperative variables.Results: 179 patients (9.3%) had infection, and 253 patients (15.2%) had colonization. The occurrence of Gram-positive species was significantly greater in the colonization group (p = 0.004). The C-reactive protein levels on the first and second postoperative days were significantly greater in the infection group (p = 0.02 and p = 0.05, respectively). The sum of all the positive cultures obtained during the postoperative period was greater in the infection group compared to the colonization group (p = 0.02). The length of the intensive care unit stay (p <0.001) was significantly longer in the infection group compared to the control group.Conclusions: Based on our results, we uncovered independent relationships between the conversion of colonization to infection regarding positive S. aureus and bloodstream results, as well as significant differences between the two groups regarding postoperative C-reactive protein levels and white blood cell counts.

Original languageEnglish
Article number166
JournalJournal of Cardiothoracic Surgery
Volume8
Issue number1
DOIs
Publication statusPublished - Jul 2 2013

Fingerprint

Thoracic Surgery
Pediatrics
Infection
Propensity Score
Postoperative Period
C-Reactive Protein
Research Ethics Committees
Leukocyte Count
Intensive Care Units
Length of Stay
Demography
Databases
Morbidity
Control Groups

Keywords

  • Cardiac surgery
  • Colonization
  • Conversion
  • Infection
  • Intensive care
  • Pediatric
  • Perioperative
  • Risk factors

ASJC Scopus subject areas

  • Surgery
  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis. / Lex, Daniel J.; Tóth, Roland; Cserép, Zsuzsanna; Breuer, Tamás; Sápi, Erzsébet; Szatmári, A.; Gál, J.; Székely, Andrea.

In: Journal of Cardiothoracic Surgery, Vol. 8, No. 1, 166, 02.07.2013.

Research output: Contribution to journalArticle

Lex, Daniel J. ; Tóth, Roland ; Cserép, Zsuzsanna ; Breuer, Tamás ; Sápi, Erzsébet ; Szatmári, A. ; Gál, J. ; Székely, Andrea. / Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis. In: Journal of Cardiothoracic Surgery. 2013 ; Vol. 8, No. 1.
@article{420c68e3cefb49e0872a5931afe833c8,
title = "Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis",
abstract = "Background: The objective of this study was to identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery.Methods: Following approval from the Institutional Review Board, patient demographics, co-morbidities, surgery details, transfusion requirements, inotropic infusions, laboratory parameters and positive microbial results were recorded during the hospital stay, and the patients were divided into two groups: patients with clinical signs of infection and patients with only positive cultures but without infection during the postoperative period. Using propensity scores, 141 patients with infection were matched to 141 patients with positive microbial cultures but without signs of infection. Our database consisted of 1665 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between the patient group with infection and the group with colonization was analyzed after propensity score matching of the perioperative variables.Results: 179 patients (9.3{\%}) had infection, and 253 patients (15.2{\%}) had colonization. The occurrence of Gram-positive species was significantly greater in the colonization group (p = 0.004). The C-reactive protein levels on the first and second postoperative days were significantly greater in the infection group (p = 0.02 and p = 0.05, respectively). The sum of all the positive cultures obtained during the postoperative period was greater in the infection group compared to the colonization group (p = 0.02). The length of the intensive care unit stay (p <0.001) was significantly longer in the infection group compared to the control group.Conclusions: Based on our results, we uncovered independent relationships between the conversion of colonization to infection regarding positive S. aureus and bloodstream results, as well as significant differences between the two groups regarding postoperative C-reactive protein levels and white blood cell counts.",
keywords = "Cardiac surgery, Colonization, Conversion, Infection, Intensive care, Pediatric, Perioperative, Risk factors",
author = "Lex, {Daniel J.} and Roland T{\'o}th and Zsuzsanna Cser{\'e}p and Tam{\'a}s Breuer and Erzs{\'e}bet S{\'a}pi and A. Szatm{\'a}ri and J. G{\'a}l and Andrea Sz{\'e}kely",
year = "2013",
month = "7",
day = "2",
doi = "10.1186/1749-8090-8-166",
language = "English",
volume = "8",
journal = "Journal of Cardiothoracic Surgery",
issn = "1749-8090",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis

AU - Lex, Daniel J.

AU - Tóth, Roland

AU - Cserép, Zsuzsanna

AU - Breuer, Tamás

AU - Sápi, Erzsébet

AU - Szatmári, A.

AU - Gál, J.

AU - Székely, Andrea

PY - 2013/7/2

Y1 - 2013/7/2

N2 - Background: The objective of this study was to identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery.Methods: Following approval from the Institutional Review Board, patient demographics, co-morbidities, surgery details, transfusion requirements, inotropic infusions, laboratory parameters and positive microbial results were recorded during the hospital stay, and the patients were divided into two groups: patients with clinical signs of infection and patients with only positive cultures but without infection during the postoperative period. Using propensity scores, 141 patients with infection were matched to 141 patients with positive microbial cultures but without signs of infection. Our database consisted of 1665 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between the patient group with infection and the group with colonization was analyzed after propensity score matching of the perioperative variables.Results: 179 patients (9.3%) had infection, and 253 patients (15.2%) had colonization. The occurrence of Gram-positive species was significantly greater in the colonization group (p = 0.004). The C-reactive protein levels on the first and second postoperative days were significantly greater in the infection group (p = 0.02 and p = 0.05, respectively). The sum of all the positive cultures obtained during the postoperative period was greater in the infection group compared to the colonization group (p = 0.02). The length of the intensive care unit stay (p <0.001) was significantly longer in the infection group compared to the control group.Conclusions: Based on our results, we uncovered independent relationships between the conversion of colonization to infection regarding positive S. aureus and bloodstream results, as well as significant differences between the two groups regarding postoperative C-reactive protein levels and white blood cell counts.

AB - Background: The objective of this study was to identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery.Methods: Following approval from the Institutional Review Board, patient demographics, co-morbidities, surgery details, transfusion requirements, inotropic infusions, laboratory parameters and positive microbial results were recorded during the hospital stay, and the patients were divided into two groups: patients with clinical signs of infection and patients with only positive cultures but without infection during the postoperative period. Using propensity scores, 141 patients with infection were matched to 141 patients with positive microbial cultures but without signs of infection. Our database consisted of 1665 consecutive pediatric patients who underwent cardiac surgery between January 2004 and December 2008 at a single center. The association between the patient group with infection and the group with colonization was analyzed after propensity score matching of the perioperative variables.Results: 179 patients (9.3%) had infection, and 253 patients (15.2%) had colonization. The occurrence of Gram-positive species was significantly greater in the colonization group (p = 0.004). The C-reactive protein levels on the first and second postoperative days were significantly greater in the infection group (p = 0.02 and p = 0.05, respectively). The sum of all the positive cultures obtained during the postoperative period was greater in the infection group compared to the colonization group (p = 0.02). The length of the intensive care unit stay (p <0.001) was significantly longer in the infection group compared to the control group.Conclusions: Based on our results, we uncovered independent relationships between the conversion of colonization to infection regarding positive S. aureus and bloodstream results, as well as significant differences between the two groups regarding postoperative C-reactive protein levels and white blood cell counts.

KW - Cardiac surgery

KW - Colonization

KW - Conversion

KW - Infection

KW - Intensive care

KW - Pediatric

KW - Perioperative

KW - Risk factors

UR - http://www.scopus.com/inward/record.url?scp=84879824493&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879824493&partnerID=8YFLogxK

U2 - 10.1186/1749-8090-8-166

DO - 10.1186/1749-8090-8-166

M3 - Article

C2 - 23819455

AN - SCOPUS:84879824493

VL - 8

JO - Journal of Cardiothoracic Surgery

JF - Journal of Cardiothoracic Surgery

SN - 1749-8090

IS - 1

M1 - 166

ER -