59. Urinary tract infection in children after cardiac surgery: Incidence, risk factors and outcome

Abstract

Urinary tract infection (UTI) can prolong hospitalization, and increase morbidity. Catheter associated UTI (CAUTI) is a major cause of UTI. The aim of this study is to determine the incidence, risk factors, etiology and outcome of UTI in postoperative cardiac children. Methods: This is retrospective cohort study. All post-operative patients admitted to PCICU during 2012 were included. Patients were divided into: group (1) Patients who developed and group (2) patients who did not develop UTI. The two groups were compared for demographic and other variable predictors for UTI. Results: 413 post-cardiac surgical children were included. Group 1 had 29 patients (7%) all had CAUTI. Foley catheter utilization ratio was 44%. CAUTI density rate was 18 per 1000 catheter days. Logistic regression analysis demonstrated that risk factors for developing UTI were: duration of Foley (P < 0.002), associated syndrome (P = 0.01) and prolonged PCICU and hospital stay (P < 0.05). Gram-negative were responsible for 63% and Candida for (24%) of the CAUTI. ESBL caused 30% and MDRO caused 10% of our patients CAUTI. Conclusions: Foley catheter duration, presence of syndrome and prolonged PCICU and hospital stay were the main risk factors for CAUTI in postoperative pediatric cardiac patients. Resistant Gram-negative were the main cause for BSI with one third of CAUTI cases caused by MDRO or ESBL organisms. The cases with CAUTI were generally sicker and with more morbidity. The study will establish a baseline clinical indicator for monitoring quality improvement and the future measures to minimize CAUTI incidence, and its co-morbidity.