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

Lookup NU author(s): Professor Bob Anderson


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© Cambridge University Press 2016 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.

Publication metadata

Author(s): Loomba RS, Pelech AN, Anderson RH

Publication type: Article

Publication status: Published

Journal: Cardiology in the Young

Year: 2017

Volume: 27

Issue: 4

Pages: 639-647

Print publication date: 01/05/2017

Online publication date: 29/09/2016

Acceptance date: 20/05/2016

ISSN (print): 1047-9511

ISSN (electronic): 1467-1107

Publisher: Cambridge University Press


DOI: 10.1017/S1047951116000962


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