Abstract
OBJECTIVE: Bloodstream infections (BSIs) are a common complication in hospitalized patients, but their incidence following open-heart surgery with delayed sternal closure (DSC) in infants with congenital heart disease (CHD) remain underexplored. This study aimed to determine the incidence of nosocomial BSIs in pediatrics undergoing open-heart surgery with DSC. A retrospective observational study was conducted using medical records of 178 infants with CHD who underwent open-heart surgery with DSC at Children's Medical Center Hospital in Iran between 2018 and 2021. Data on demographic characteristics, surgical variables, and blood culture results were collected. Statistical analysis was performed using SPSS version 24, with a significance level of 0.05. RESULTS: The incidence of nosocomial BSIs was 11.8% (21 of 178 infants). Among the positive cultures, Klebsiella was the most frequent pathogen, accounting for 47.6% of isolates (10 out of 21). Among the positive cultures, Klebsiella was the most frequent pathogen, accounting for 10 (47.6%) of isolates. Multivariable logistic regression analysis revealed that younger age (adjusted OR 0.97 per day; 95% CI 0.94-0.99; P = 0.03) and longer cardiopulmonary bypass (CPB) duration (adjusted OR 1.008 per minute; 95% CI 1.000-1.016; P = 0.04) were independently associated with the occurrence of BSI. These findings suggest that younger age and prolonged cardiopulmonary bypass duration are independent risk factors for the development of BSIs bloodstream infections in pediatric patients undergoing open-heart surgery with DSC. Further research is warranted to validate these findings and to identify effective infection prevention strategies for this high-risk population.