Table 1.

Report of research

Author/s (year), title	Study design	Purpose	Sample size and sites	Key findings/comments
Bath et al. (2016), Impact of standardization of antimicrobial prophylaxis duration in pediatric cardiac surgery	Almost experimental study	To evaluate the clinical impact after implementation of a protocol that limited postoperative prophylaxis to 48 hours following sternal closure in pediatric cardiac surgery.	Patients 18 years and younger who underwent cardiac surgery from April 2011 to November 2014 at a single institution	The implementation of a protocol limiting antimicrobial prophylaxis to 48 hours following sternal closure.
Cannon et al. (2016), Improving surveillance and prevention of surgical site infection in pediatric cardiac surgery.	Almost experimental study	To implement the surgical surveillance of wounds and reduce the incidence of surgical site infections in patients undergoing cardiac surgery.	Infants and children underwent cardiac surgery within 30 days by the operation.	The surveillance of the cardiac surgery wound and the introduction of process and surveillance measures based on NHSH guidelines for the prevention of SSIs.
Caruso et al. (2018), A Postoperative Care Bundle Reduces Surgical Site Infections in Pediatric Patients Undergoing Cardiac Surgeries.	Quality improvement (QI)	To study a postoperative SSI reduction care bundle for pediatric patients after cardiac surgery.	Pediatric patient after cardiac surgery from January 1, 2013, through May 31, 2015, and an intervention/sustainment period from June 1, 2015, through March 30, 2017.	Describes five key drivers and 11 elements that were dedicated to reducing the risk of SSI during prolonged CVICU recoveries from pediatric cardiac surgery.
Costello et al. (2010), Risk factors for surgical site infection after cardiac surgery in children	Matched case-control study (Retrospective)	To identify risk factors for any type of surgical site infections (SSI) in children undergoing cardiac surgery in a large congenital heart program.	All patients experiencing any type of SSI after undergoing cardiac surgery at Children’s Hospital Boston from January 2004 through December 2006.	Prevention of SSI.
Delgado-Corcoran et al. (2017), Reducing pediatric sternal wound infections: a quality improvement project. Pediatric Critical Care Medicine	Qualitative study	The implementation of a bundle for the prevention of surgical site infections.	Pediatric patients undergoing cardiac surgery by median sternotomy, from January 2010 to December 2014.	To reduce the incidence of cardiac site infections in users undergoing delayed sternal closure.
Harder et al. (2013), Risk factors for surgical site infection in pediatric cardiac surgery patients undergoing delayed sternal closure.	Case-control study	To determine the incidence and risk factors for SSI in users undergoing cardiac surgery with delayed sternal closure.	375 pediatric patients (aged <18 years) undergoing delayed sternal closure, between January 1, 2005, and December 31, 2009.	To find new treatment strategies for the prevention and prophylaxis of SSI in pediatric intensive care.
Hatachi et al. (2019), Antibiotic Prophylaxis for Open Chest Management After Pediatric Cardiac Surgery.	Retrospective, single-center, observational study	To compare the occurrence rates of bloodstream infection and surgical site infection between the different prophylactic antibiotic regimens for open-chest management after pediatric cardiac surgery.	Patients younger than or equal to 18 years old with open chest management after cardiac surgery followed by delayed sternal closure, between January 2012 and June 2018 in a PICU at a tertiary children’s hospital.	To reduce SSIs and BSIs for open-chest pediatric patients after cardiac surgery
Kansy et al. (2012), Major infection after pediatric cardiac surgery: external validation of risk estimation model	Retrospective analysis	To validate externally the Society of Thoracic Surgeons (STS) risk estimation model and verify its specific risk factors using a single institution’s complete and verified database.	Patients 18 years or younger at their institution who between 1995 and 2010 underwent major congenital heart surgery procedures classified using both ABC and RACHS-1.	The clinical impact of the model developed using STS Congenital heart Surgery data as a tool for predicting serious postoperative infections and providing information that can and should be used for prevention and neutralization of the risk of this major complication.
Katayanagi et al. (2015), Nasal methicillin-resistant S. aureus is a major risk for mediastinitis in pediatric cardiac surgery.	Retrospective study	To investigate the preoperative, intraoperative, and postoperative factors that are associated with the occurrence of mediastinitis.	Patients aged < or = 15 years who underwent pediatric open-heart surgery between October 2002 and October 2010.	The success of the comprehensive SSI prevention measures implemented in their hospital.
Lex et al. (2013), Postoperative differences between colonization and infection after pediatric cardiac surgery-a propensity matched analysis	Prospective single-center study	To identify the postoperative risk factors associated with the conversion of colonization to postoperative infection in pediatric patients undergoing cardiac surgery.	Pediatric (<18 years) patients between January 1, 2004, and December 31, 2008.	The comparison between bacterial colonization and the clinical infection in the pediatric cardiac population.
Macher et al. (2016), Preoperative Staphylococcus aureus Carriage and Risk of Surgical Site Infection After Cardiac Surgery in Children Younger than 1 year: A Pilot Cohort Study	Monocentric prospective pilot cohort study	To describe the prevalence of Staphylococcus Aureus (SA) colonization in children under 1 year old before cardiac surgery.	Children <1 year old, undergoing cardiac surgery under cardiopulmonary bypass from May 2012 to November 2013.	The association between SA colonization and surgical site infections (SSI) incidence.
Murray et al. (2014a), Surgical site infections and bloodstream infections in infants after cardiac surgery.	Retrospective cohort study	To determine the incidence of surgical site infections (SSIs) and bloodstream infections (BSIs) in infants after cardiac surgery.	470 infants (aged <1-year-old) undergoing cardiac surgery from January 2010 to December 2011.	To identify the risk factors, the responsible pathogens and their susceptibility to antimicrobial agents.
Murray et al. (2014b), Implementing a standardized perioperative antibiotic prophylaxis protocol for neonates undergoing cardiac surgery.	Almost experimental study	To develop a standardized perioperative antibiotic prophylaxis protocol for neonates undergoing cardiac surgery.	Infants who underwent cardiac surgery from 1 July 2009 to 30 June 2012.	To assess compliance with selected process measures for perioperative antibiotic prophylaxis.
Nayar et al. (2016), Improving Cardiac Surgical Site Infection Reporting and Prevention By Using Registry Data for Case Ascertainment	Quality improvement (QI)	Linking clinical registry and infection surveillance data to the electronic health record data to improve identification of at-risk cases, adjudicating and resolving differences across the various data sources, visualizing surgical site infections (SSI) rates according to the different data sourced and criteria, and implementing QI interventions to decrease the incidence of SSI.	Children’s Hospital of Philadelphia SSI data from January 2013 to December 2014	Integrating clinical registry data with administrative and infection surveillance data for more accurate SSI rates.
Nelson-McMillan et al. (2016), Delayed Sternal Closure in Infant Heart Surgery-The Importance of Where and When: An Analysis of the STS Congenital Heart Surgery Database	Regression analysis	The evaluation of the rate of infectious complications associated with maintenance of an open sternum in the infant cardiac surgery population.	Infants (age 0 to 365 days) undergoing open-heart surgery at center participating in the Society of Thoracic Surgeons Congenital Heart Surgery database from January 1, 2007, through December 31, 2013.	Maintaining an open sternum for a few days is associated with a considerable risk of infection.
Sen et at. (2017), Postoperative Infection in Developing World Congenital Heart Surgery Programs: Data From the International Quality Improvement Collaborative	Quality improvement (QI)	To identify risk factors for postoperative infection and the impact on outcomes after congenital heart surgery.	Congenital heart surgery in patients < 18 years of age between January 2010 and Decembre 2012.	To provide a platform for a robust data collection, data reports for self-evaluation, and an educational program for quality improvement.
Silvetti et al. (2017), Preoperative colonization in pediatric cardiac surgery and its impact on postoperative infections	Retrospective cohort study	To verify the association between colonization and clinical infection.	Patients aged < or = 18 years who underwent pediatric open-heart surgery in the years 2015.	Patient colonization and antimicrobial prophylaxis.
Sochet et al. (2017), Surgical Site Infection After Pediatric Cardiothoracic Surgery.	Matched cohort study (Retrospective)	To assess the health-care cost and resource utilization associated with surgical site infections (SSI) in children.	Children (aged 0 to 18 years) with deep and organ/space SSI after cardiothoracic surgery (CTS), from January 2010 to December 2013.	The attributable hospital cost associated with SSI following pediatric CTS.
Staveski et al. (2016), Silver-Impregnated dressings for sternotomy incision to prevent surgical site infections in children.	Clinical prospective randomized controlled trial	The identification and drafting of a multidisciplinary protocol to evaluate the effectiveness of silver impregnated dressing, Silver with the aim of reducing SSI in children undergoing cardiac surgery.	Patients aged under 18 years old with congenital heart disease undergoing by median sternotomy.	The prevention of the SSI.
Turcotte et al. (2014), Health care-associated infections in children after cardiac surgery	Retrospective cohort study	To assess the epidemiology of several types of health care-associated infections (HAIs).	Children 18 years of age or younger undergoing cardiac surgery from July 2010 to June 2012.	To find potentially modifiable pre-, intra-, and postoperative risk factors.
Woodward et al. (2011), Sternal wound infections in pediatric congenital cardiac surgery: a survey of incidence and preventative practice	Survey study	To determine the incidence of and preventative practice regarding pediatric sternal wound infections with a long-term aim to develop best practice guidelines.	Children less than 18 years of age.	Pre, intra and postoperative measures to prevent sternal wound infections.
Woodward et al. (2017), Multicenter Quality Improvement Project to Prevent Sternal Wound Infections in Pediatric Cardiac Surgery Patients	Quality Improvement (QI)	To improve the health care of children by evaluating the efficacy of a protocolized approach to reduce Sternal wound infection.	Patients up to 18 years of age, who underwent sternotomy for cardiac surgery from July 1, 2013, to June 30, 2015.	The importance of adhering to a standardized protocol.