Risk Factors of Sepsis & Prevalence of Multidrug Resistant Organism in Pediatric Cardiac Surgery 1n a Rural Tertiary Care Teaching Hospital in India

Background: Cardiac surgery and cardiopulmonary bypass lead to an immunoparalyzed state in children which makes them susceptible to sepsis and other hospital acquired infections. Identification of risk factors of sepsis would lead to appropriate management

Objective: The present study was conducted to assess the prevalence of sepsis and risk factors associated with sepsis in pediatric cardiac surgical patients and the subsequent prevalence of multidrug resistant organisms.

Methods: A Retrospective, single-center observational study was conducted on 100 pediatric patients admitted to the PICU after cardiac surgery between January 2017 and February 2018. All the data of the patients were collected from the medical record department of the hospital. Patient case report form consisted of demography, surgery details, Pre-operative & post-operative haematological reports and clinical details. After collecting the data, Chi-square test and logistic regression analysis were used to find the risk factors associated with sepsis.

Results: The prevalence of sepsis in our population was 27% and mortality rate due to sepsis was 1%. The only statistically significant risk factor for sepsis we found in this study was prolonged ICU (intensive care unit) stay for more than 5 days. Total 8 patients had blood culture positive for bacterial infection. The alarming finding was that all 8 were multidrug resistant organisms, requiring the last line of antibacterials.

Conclusion: Our study implies that special clinical care is required when ICU stay is prolonged to mitigate the risk of sepsis. These new and upcoming infections not only lead to high mortality and morbidity rates but also contribute to increased cost of care due to the use of newer broad-spectrum antibiotics and longer hospital stay. The high prevalence of multidrug resistant organisms is unacceptable in the current scenario and hospital infection and prevention control play a critical role in minimizing such infections.