Risk Factors and Microbiological Characterization of Healthcare Associated Infection Post Cardiac Surgery Among Children in Beijing, China.

OBJECTIVE: Healthcare associated infection (HAI) in children after open-heart surgery contributes substantially to morbidity and mortality. We aimed to analyze the clinical and microbiological characteristics of HAI after pediatric cardiac surgery. METHODS: This single-center retrospective study was conducted in Beijing Children's Hospital from July 1, 2022 to June 30, 2025 including children with congenital heart disease (CHD) who underwent open-heart surgeries. RESULTS: A total of 1206 patients were included in this study. The overall HAI rate was 13.6%. Multivariate logistic regression analysis found underlying diseases (odds ratio [OR] = 12.342; 95% confidence interval [CI]: 5.744-26.518; P < 0.001), moderate and severe preoperative pulmonary artery hypertension (pre-PAH) (OR = 3.141; 95% CI: 1.311-7.527; P = 0.010 and OR = 3.312; 95% CI: 1.407-7.797, P = 0.006), and aortic cross-clamping (ACC) time (OR = 1.026; 95% CI: 1.008-1.045; P = 0.004) were significantly associated with postoperative HAI. Additionally, no significant association was observed between glucocorticoid use and postoperative HAI in our study. Of the 238 organisms detected, bacteria predominated (55.9%, 133/238). Gram-negative bacilli accounted for 89.5% (119/133) of the bacterial isolates, and Klebsiella pneumoniae was the only multi-drug resistant organism (MDRO) identified. CONCLUSION: Our study suggested underlying diseases, moderate and severe pre-PAH, and ACC time were independently associated with postoperative HAI. Klebsiella pneumoniae was the only MDRO among the most common gram-negative bacilli.