• Xindi Yu, Maolin Chen, Xu Liu, Yiwei Chen, Zedong Hao, Haibo Zhang, and Wei Wang.
• Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong district, Shanghai, China.
• Bmc Infect Dis. 2020 Jan 21; 20 (1): 64.

BackgroundThe aim of our study was to analyze the risk factors of nosocomial infection after cardiac surgery in children with congenital heart disease (CHD).MethodsWe performed a retrospective cohort study, and children with CHD who underwent open-heart surgeries at Shanghai Children's Medical Center from January 1, 2012 to December 31, 2018 were included. The baseline characteristics of these patients of different ages, including neonates (0-1 months old), infants (1-12 months old) and children (1-10 years old), were analyzed, and the association of risk factors with postoperative nosocomial infection were assessed.ResultsA total of 11,651 subjects were included in the study. The overall nosocomial infection rate was 10.8%. Nosocomial infection rates in neonates, infants, and children with congenital heart disease were 32.9, 15.4, and 5.2%, respectively. Multivariate logistic regression analysis found age (OR 0798, 95%CI: 0.769-0.829; P < 0.001), STS risk grade (OR 1.267, 95%CI: 1.159-1.385; P < 0.001), body mass index (BMI) <5th percentile (OR 1.295, 95%CI: 1.023-1.639; P = 0.032), BMI >95th percentile (OR 0.792, 95%CI: 0.647-0.969; P = 0.023), cardiopulmonary bypass (CPB) time (OR 1.008, 95%CI: 1.003-1.012; P < 0.001) and aortic clamping time (OR 1.009, 1.002-1.015; P = 0.008) were significantly associated with nosocomial infection in CHD infants. After adjusted for confounding factors, we found STS risk grade (OR 1.38, 95%CI: 1.167-1.633; P < 0.001), BMI < 5th percentile (OR 1.934, 95%CI: 1.377-2.715; P < 0.001), CPB time (OR 1.018, 95%CI: 1.015-1.022; P < 0.001), lymphocyte/WBC ratiocut off value (OR 1.546, 95%CI: 1.119-2.136; P = 0.008) were significantly associated with nosocomial infection in CHD children.ConclusionOur study suggested STS risk grade, BMI, CPB duration, low lymphocyte/WBC or high neutrophil/WBC ratio were independently associated with nosocomial infection in CHD infant and children after cardiac surgery.

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