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Factors influencing bacteraemia in patients with isomerism and CHD: the effects of functional splenic status and antibiotic prophylaxis

Published online by Cambridge University Press:  29 September 2016

Rohit S. Loomba ,
Andrew N. Pelech  and
Robert H. Anderson
Rohit S. Loomba*
Affiliation:
Department of Pediatric Cardiology, Children’s Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
Andrew N. Pelech
Affiliation:
Department of Pediatric Cardiology, Children’s Hospital of Wisconsin/Medical College of Wisconsin, Milwaukee, Wisconsin, United States of America
Robert H. Anderson
Affiliation:
Institute of Genetic Medicine, Newcastle University, Newcastle Upon Tyne, United Kingdom
*
Correspondence to: R. S. Loomba, Department of Pediatric Cardiology, Children’s Hospital of Wisconsin/Medical College of Wisconsin, 9000 Wisconsin Avenue, Milwaukee, WI 53226, United States of America. Tel: 414 266 2000; Fax: 414 266 3855; E-mail: Loomba.rohit@gmail.com
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Abstract

Background

“Heterotaxy syndrome”, best segregated as isomerism, is characterised by laterality defects of the thoraco-abdominal organs, causing functional impairment. In particular, the spleen is frequently affected, increasing susceptibility to bacteraemia. This study explored factors that may increase the risk of bacteraemia in patients with isomerism.

Methods

We identified patients with CHD and isomerism. Review of outpatient, inpatient, and surgical records was conducted to collect data and determine trends in the cohort. A Cox regression analysis was conducted to determine factors influencing freedom from bacteraemia (Fig 1).

Results

We identified 83 patients with CHD and isomerism – 17 (20%) who had documented episodes of bacteraemia with a total of 21 episodes. A majority (86%) were nosocomial. The median age at the time of bacteraemia was 4 months. Although splenic anatomy did appear to influence the risk of bacteraemia in univariate analysis, this significance was lost with multivariate analysis. None of the other factors was significantly associated in either univariate or multivariate analysis.

Conclusion

Specific factors such as splenic anatomy, atrial appendage isomerism, and antibiotic prophylaxis status are not significantly associated with the risk of bacteraemia in patients with CHD and isomerism. Nosocomial infections represent a majority of bacteraemia in these patients.

Keywords

Isomerismheterotaxybacteraemiaantibioticsaspleniapolysplenia
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 4 , May 2017 , pp. 639 - 647
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Copyright
© Cambridge University Press 2016 

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