الفهرس 
Title : Impact of Bacterial Colonization on Post-Operative Open-Heart Cardiac Surgeries and Current Changes of Antibiogram Pattern
ContentsOnly 14 pages are availabe for public view
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Abstract
: Early studies of the incidence of CHD produced low incidences of about 4 to 5 per 1,000 live births, but this figure has been rising steadily until recently when incidences of 12 to 14/1,000 live births, or higher, have been reported in the literature. The following is the order of CHD in term of incidence from the highest to the lowest: VSD, PDA, ASD, AVSD, PS, AS, Coarc, Tetralogy of Fallot, D-TGA, HRH, Tricuspid atresia, Ebstein’s anomaly, Pulmonary atresia, HLH, Truncusarteriosus, DORV, SV and TAPVR. Nosocomial infections (NI) are those that are acquired in a hospital setting. The Centre for Disease Control and Prevention (CDC) defines ICU associated infections as those that occur after 48 hours of ICU admission or within 48 hours after transfer from an ICU. A growing body of evidence supports the contribution of Healthcare workers’ hands in being the major vector of cross-transmission of pathogens, with an estimated 20 to 40 % of nosocomial infections arising from cross-infections via healthcare personnel handsThis study was a descriptive cohort study to evaluate the presence of bacterial colonization on HCWs’ hand and nasal swabs and their contribution in transmitting infection to the patients affecting the LOS and the outcome of cardiac surgeries in the post-operative cardiac care unit, Cairo Specialized Pediatric Hospitals – Cairo University.
Objective: We aim to assess the effect of bacterial colonization on HCWs’ hand and nasal swabs on the outcome of congenital cardiac surgeries in being a source in contracting nosocomial infection in the CCU, increasing the rate of infection, transmitting infection between a patient and another, prolongating the CCU LOS and increasing mortality rate in the CCU.
Patients and Methods: This descriptive cohort study is based on data collected from children with congenital heart disease who underwent an open-heart surgery whether an open or a closed one and were admitted in the post operative CCU on the fifth flour in Cairo Specialized Pediatric Hospitals – Cairo University from January 2021 to December 2021.
Results: Data showed that 92.5% of the HCWs’ hand swabs and 82.5% of their nasal swabs were positive with different organism like klebsiella species being the most common, staphylococcus aureus, coagulase negative staph, Acinetobacter species, candida species and other organisms. These HCWs were handling patients in the CCU whose ETA or Blood culture as well as their axillary or nasal swabs showed similar organisms in the same settings of their withdrawal.
This was statistically evident by the results showing that 82.5% (33/40) of the patients’ ETA cultures showed infection with klebsiella species where 59% (19/33) had also positive klebsiella culture in their nasal swabs (P-value = 0.031). Also, the results showed that out the 82.5% positive ETA culture, 81% (24/33) of the HCWs’ hand swabs showed infection with the same organisms which is statically significant (P-value = 0.017). this however reflected on the LOS where the median (IQR) of hospital stay was higher 18.5 (8-40) in patients with positive ETA culture than in patients with negative ETA culture 12 (8 – 25) (P-value = 0.031). Also, it reflected on the mortality rate of the CCU where 91% (21/23) of mortality cases had an ETA culture showing infection with klebsiella species and out of the 17 discharged patients, only 58.8% (10/17) showed ETA culture with klebsiella species which was statistically significant (P-value = 0.041).
Conclusion: HCWs are considered to be a source in nosocomial infection in the post operative congenital cardiac surgeries as they play an important role in either transmitting infection to their patients or transmitting it between one patient to another which greatly affect the outcome of cardiac surgeries and the duration of hospital stay.