Catheter‐associated bloodstream infection incidence and outcomes in congenital cardiac surgery

Objective: Catheter‐associated bloodstream infections complicate and prolong hos‐ pitalizations. 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 out‐ comes and costs to those who underwent surgery and did not have a catheter‐associ‐ ated bloodstream infections.
Design: 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 ana‐ lytic 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 uti‐ lized. 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.
Results: Catheter‐associated bloodstream infections incidence after congenital car‐ diac 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‐as‐ sociated bloodstream infections.
Conclusion: 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.