Skip to main content
SpringerLink
Log in

Infections in the Cardiac Intensive Care Unit

  • Chapter
  • First Online:
Critical Care of Children with Heart Disease

  • 3772 Accesses

Abstract

Children in the cardiac intensive care unit (CICU) are at a high risk for infections. This may be due to underlying immunodeficiency, iatrogenic alterations in the immune system or due to invasive procedures. Some patients are admitted to the CICU primarily due to an infection, while others develop secondary infections once they are in the CICU setting. This chapter reviews the types of infections that can occur in the pediatric CICU to give an understanding of predisposing factors, primary and secondary infections.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Parshuram CS, Doyle J, Lau W, et al. Transfusion-associated graft versus host disease. Pediatr Crit Care Med. 2002;3(1):57-62.

    Article  PubMed  Google Scholar 

  2. Varan B, Tokel K, Yilmaz G. Malnutrition and growth failure in cyanotic and acyanotic congenital heart disease with and without pulmonary hypertension. Arch Dis Child. 1999;81:49-52.

    Article  PubMed  CAS  Google Scholar 

  3. Levy I, Ovadia B, Erez E, et al. Nosocomial infections after cardiac surgery in infants and children: incidence and risk factors. J Hosp Infect. 2003;53:111-116.

    Article  PubMed  CAS  Google Scholar 

  4. O’Neill JM, Schutze GE, Heulitt MJ, et al. Nosocomial infections during extracorporeal membrane oxygenation. Intensive Care Med. 2001;27:1247-1253.

    Article  PubMed  Google Scholar 

  5. Goldberg SP, Bradley JW, Aaron MF, et al. Fungal infections in ventricular assist devices. ASAIO J. 2000;46:S37-S40.

    Article  PubMed  CAS  Google Scholar 

  6. Simon D, Fischer S, Grossman A, et al. Left ventricular assist device-related infection: treatment and outcome. Clin Infect Dis. 2005;40:1108-1115.

    Article  PubMed  Google Scholar 

  7. Lee KR, Ring JC, Leggiadro RJ. Prophylactic antibiotic use in pediatric cardiovascular surgery: a survey of current practice. Pediatr Infect Dis J. 1995;14:267-269.

    Article  PubMed  CAS  Google Scholar 

  8. Bratzler DW, Houck PM. Surgical Infection Prevention Guidelines Writers Workshop. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Clin Infect Dis. 2004;38:1706-1715.

    Article  PubMed  Google Scholar 

  9. Mangram AJ, Horan TC, Pearson ML, et al. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999;20:250-278.

    Article  PubMed  CAS  Google Scholar 

  10. Tortoriello TA, Friedman JD, McKenzie ED, et al. Mediastinitis after pediatric cardiac surgery: a 15-year experience at a single institution. Ann Thorac Surg. 2003;76:1655-1660.

    Article  PubMed  Google Scholar 

  11. Huddleston CB. Mediastinal wound infections following pediatric cardiac surgery. Semin Thorac Cardiovasc Surg. 2004;16:108-112.

    Article  PubMed  Google Scholar 

  12. Long CB, Shah SS, Lautenbach E, et al. Postoperative mediastinitis in children: epidemiology, microbiology and risk factors for Gram-negative pathogens. Pediatr Infect Dis J. 2005;24:315-319.

    Article  PubMed  Google Scholar 

  13. Mermel LA, Farr BM, Sherertz RJ, et al. Infectious Diseases Society of America: American College of Critical Care Medicine: Society for Health Care Epidemiology of America. Guidelines for the management of intravascular catheter-related infections. J Intraven Nurs. 2001;24:180-205.

    PubMed  CAS  Google Scholar 

  14. Shah SS, Smith MJ, Zoutis TE. Device-related infections in children. Pediatr Clin North Am. 2005;52:1189-1208.

    Article  PubMed  Google Scholar 

  15. O’Grady NP, Alexander M, Dellinger EP, et al. Healthcare Infection Control Practices Advisory Committee. Guidelines for the prevention of intravascular catheter-related infections. Infect Control Hosp Epidemiol. 2002;23:759-769.

    Article  PubMed  Google Scholar 

  16. Garland JS, Alex CP, Hendrikson KJ, et al. A vancomycin-heparin lock solution for prevention of nosocomial bloodstream infection in critically ill neonates with peripherally inserted central venous catheters: a prospective, randomized trial. Pediatrics. 2005;116:e198-e205.

    Article  PubMed  Google Scholar 

  17. Tan L, Sun X, Zhu X, et al. Epidemiology of nosocomial pneumonia in infants after cardiac surgery. Chest. 2004;125:410-417.

    Article  PubMed  Google Scholar 

  18. Pomper G, Wu Y, Snyder EL. Risks of transfusion-transmitted infections: 2003. Curr Opin Hematol. 2003;10:412-418.

    Article  PubMed  Google Scholar 

  19. Dodd RY. Current safety of the blood supply in the United States. Int J Hematol. 2004;80:301-305.

    Article  PubMed  Google Scholar 

  20. Qu L, Xu S, Rowe D, Triulzi D. Efficacy of Epstein-Barr virus removal by leukoreduction of red blood cells. Transfusion. 2005;45:591-595.

    Article  PubMed  Google Scholar 

  21. Bowles NE, Ni J, Kearney DL, et al. Detection of viruses in myocardial tissues by polymerase chain reaction. evidence of adenovirus as a common cause of myocarditis in children and adults. J Am Coll Cardiol. 2003;42:466-472.

    Article  PubMed  Google Scholar 

  22. Martin AB, Webber S, Fricker FJ, et al. Acute myocarditis. Rapid diagnosis by PCR in children. Circulation. 1994;90:330-339.

    Article  PubMed  CAS  Google Scholar 

  23. Zack F, Klingel K, Kandolf R, et al. Sudden cardiac death in a 5-year-old girl associated with parvovirus B19 infection. Forensic Sci Int. 2005;155:13-17.

    Article  PubMed  CAS  Google Scholar 

  24. Tabbutt S, Leonard M, Godinez RI, et al. Severe influenza B myocarditis and myositis. Pediatr Crit Care Med. 2004;5:403-406.

    Article  PubMed  Google Scholar 

  25. Kyto V, Vuorinen T, Saukko P, et al. Cytomegalovirus infection of the heart is common in patients with fatal myocarditis. Clin Infect Dis. 2005;40:683-638.

    Article  PubMed  Google Scholar 

  26. Noren GR, Stanley NA, Bandt CM, et al. Occurrence of myocarditis in sudden death in children. J Forensic Sci. 1977;22:188-196.

    PubMed  CAS  Google Scholar 

  27. Levi D, Alejos J. An approach to the treatment of pediatric myocarditis. Paediatr Drugs. 2002;4:637-647.

    PubMed  Google Scholar 

  28. Robinson J, Hartling L, Vandermeer B, et al. Intravenous immunoglobulin for presumed viral myocarditis in children and adults. Cochrane Database Syst Rev. 2005;1:CD004370.

    PubMed  Google Scholar 

  29. Drucker NA, Colan SD, Lewis AB, et al. Gamma-globulin treatment of acute myocarditis in the pediatric population. Circulation. 1994;89:252-257.

    Article  PubMed  CAS  Google Scholar 

  30. McNara DM, Holubkov R, Starling RC, et al. Controlled trial of intravenous immune globulin in recent-onset dilated cardiomyopathy. Circulation. 2001;103:2254-2259.

    Article  Google Scholar 

  31. Rotbart HA, Webster AD, Pleconaril Treatment Registry Group. Treatment of potentially life-threatening enterovirus infections with pleconaril. Clin Infect Dis. 2001;32:228-235.

    Article  PubMed  CAS  Google Scholar 

  32. Khongphattanayouthin A, Wong PC, Samara Y, et al. Impact of respiratory synsytial virus infection on surgery for congenital heart disease: Postoperative course and outcome. Crit Care Med. 1999;27:1974-1981.

    Article  Google Scholar 

  33. Altman CA, Englund JA, Demmler G, et al. Respiratory syncytial virus in patients with congenital heart disease: a contemporary look at epidemiology and success of preoperative screening. Pediatric Cardiology. 2000;21:433-438.

    Article  PubMed  CAS  Google Scholar 

  34. Apalsch AM, Green M, Ledesma-Medina J, et al. Parainfluenza and influenza virus infections in pediatric organ transplant recipients. Clin Infect Dis. 1995;20:394-399.

    Article  PubMed  CAS  Google Scholar 

  35. Rubin RH, Kemmerly SA, Conti D, et al. Prevention of primary cytomegalovirus disease in organ transplant recipients with oral ganciclovir or oral acyclovir prophylaxis. Transpl Infect Dis. 2000;2:112-117.

    Article  PubMed  CAS  Google Scholar 

  36. Green M. Management of Epstein-Barr virus-induced post-transplant lymphoproliferative disease in recipients of solid organ transplantation. Am J Transplant. 2001;1:103-108.

    PubMed  CAS  Google Scholar 

  37. Boyle G, Michaels MG, Webber SA, et al. Posttransplantation lymphoproliferative disorders in pediatric thoracic organ recipients. J Pediatr. 1997;131:309-313.

    Article  PubMed  CAS  Google Scholar 

  38. Cockfield SM. Identifying the patient at risk for post-transplant lymphoproliferative disorder. Transpl Infect Dis. 2001;3:70-78.

    Article  PubMed  CAS  Google Scholar 

  39. Wasson S, Zafar MN, Best J, et al. Post-transplantation lymphoproliferative disorder in heart and kidney transplant patients: a single-center experience. J Cardiovasc Pharmacol Ther. 2006;11:77-83.

    Article  PubMed  Google Scholar 

  40. Opelz G, Henderson R. Incidence of non-Hodgkin lymphoma in kidney and heart transplant recipients. Lancet. 1993;342:1514-1516.

    Article  PubMed  CAS  Google Scholar 

  41. Swinnen LJ, Mullen GM, Carr TJ, et al. Aggressive treatment for postcardiac transplant lymphoproliferation. Blood. 1995;86:3333-3340.

    PubMed  CAS  Google Scholar 

  42. Avery RK, Longworth DL. Viral pulmonary infections in thoracic and cardiovascular surgery. Semin Thorac Cardiovasc Surg. 1995;7:88-94.

    PubMed  CAS  Google Scholar 

  43. Weigl JA, Puppe W, Schmitt HJ. The incidence of influenza-associated hospitalization in children in Germany. Epidemiol Infect. 2002;129:525-533.

    Article  PubMed  CAS  Google Scholar 

  44. American Academy of Pediatrics. Respiratory Syncytial Virus. In: Pickering LK, Baker CJ, Long SS, McMillan JA, eds. Red Book: 2006 Report of the Committee on Infectious Diseases. 27th ed. Elk Grove Village. IL: American Academy of Pediatrics; 2006:562-565.

    Google Scholar 

  45. Admon D, Engelhard D, Strauss N, et al. Antibody response to influenza immunization in patients after heart transplantation. Vaccine. 1997;15:1518-1522.

    Article  PubMed  CAS  Google Scholar 

  46. Macdonald L, Baker C, Chenowith C. Risk factors for candidemia in a children’s hospital. Clin Infect Dis. 1998;26:642-645.

    Article  PubMed  CAS  Google Scholar 

  47. Garcia-San Miguel L, Cobo J, Martos I, et al. Risk factors for candidemia in pediatric patients with congenital heart disease. Infect Control Hosp Epidemiol. 2006;27:576-580.

    Article  PubMed  Google Scholar 

  48. Zaoutis TE, Greves HM, Lautenbach E, et al. Risk factors for disseminated candidiasis in children with candidemia. Pediatr Infect Dis J. 2004;23:635-641.

    Article  PubMed  Google Scholar 

  49. Rex JH, Walsh TJ, Sobel JD, et al. Practice guidelines for the treatment of candidiasis. Infectious Diseases Society of America. Clin Infect Dis. 2000;30:662-678.

    Article  PubMed  CAS  Google Scholar 

  50. Keough WL, Michaels MG. Infectious complications in pediatric solid organ transplantation. Pediatr Clin North Am. 2003;50:1451-1469.

    Article  PubMed  Google Scholar 

  51. Hermanns B, Brunn A, Schwartz ER, et al. Fulminant toxoplasmosis in a heart transplant recipient. Pathol Res Pract. 2001;197:211-215.

    Article  PubMed  CAS  Google Scholar 

  52. Michaels NG, Wald ER, del Nido PJ, Armitage J. Toxoplasmosis in pediatric recipients of heart transplants. Clin Infect Dis. 1992;14:847-851.

    Article  PubMed  CAS  Google Scholar 

  53. Gallino A, Maggiorini M, Kiowski W, et al. Toxoplasmosis in heart transplant recipients. Eur J Clin Microbiol Infect Dis. 1996;15:389-393.

    Article  PubMed  CAS  Google Scholar 

  54. Baden LR, Katz JT, Franck L, et al. Successful toxoplasmosis prophylaxis after orthotopic cardiac transplantation with trimethoprim-sulfamethoxazole. Transplantation. 2003;75:339-343.

    Article  PubMed  CAS  Google Scholar 

  55. Archibald LK, Manning ML, Bell LM, et al. Patient density, nurse-to-patient ratio and nosocomial infection risk in a pediatric cardiac intensive care unit. Pediatr Infect Dis J. 1997;16:1045-1048.

    Article  PubMed  CAS  Google Scholar 

  56. Romero JR. Palivizumab prophylaxis of respiratory syncytial virus disease from 1998 to 2002: results from four years of palivizumab usage. Pediatr Infect Dis J. 2003;22:S46-S54.

    PubMed  Google Scholar 

  57. Cabalka AK. Physiologic risk factors for respiratory viral infections and immunoprophylaxis for respiratory syncytial virus in young children with congenital heart disease. Pediatr Infect Dis J. 2004;23:S41-S45.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Infectious Diseases, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, USA

    Glenda V. Wright

Authors
  1. Glenda V. Wright
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marian G. Michaels
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Glenda V. Wright .

Editor information

Editors and Affiliations

  1. Children's Hospital, Pittsburgh, 5th Ave. 3705, Pittsburgh, 15213, USA

    Ricardo Munoz

  2. School of Medicine, Children's Hospital, University of Pittsburgh, Fifth Ave. 3705, Pittsburgh, 15213, USA

    Victor Morell

  3. Chemin de Normanie 2, Geneve, 1206, Switzerland

    Eduardo Cruz

  4. Children's Hospital, Pittsburgh, 5th Ave. 3705, Pittsburgh, 15213, USA

    Carol Vetterly

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Springer-Verlag London Limited

About this chapter

Cite this chapter

Wright, G.V., Michaels, M.G. (2009). Infections in the Cardiac Intensive Care Unit. In: Munoz, R., Morell, V., Cruz, E., Vetterly, C. (eds) Critical Care of Children with Heart Disease. Springer, London. https://doi.org/10.1007/978-1-84882-262-7_62

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-262-7_62

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-261-0

  • Online ISBN: 978-1-84882-262-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation