{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:11:02Z","timestamp":1787508662192,"version":"build-2736575974"},"reference-count":49,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2016,9,29]],"date-time":"2016-09-29T00:00:00Z","timestamp":1475107200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951116000962_abs1\" sec-type=\"general\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\u201cHeterotaxy syndrome\u201d, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951116000962_abs2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951116000962_abs3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 83 patients with CHD and isomerism \u2013 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951116000962_abs4\" sec-type=\"conclusion\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951116000962","type":"journal-article","created":{"date-parts":[[2016,9,29]],"date-time":"2016-09-29T05:49:49Z","timestamp":1475128189000},"page":"639-647","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":7,"title":["Factors influencing bacteraemia in patients with isomerism and CHD: the effects of functional splenic status and antibiotic prophylaxis"],"prefix":"10.1017","volume":"27","author":[{"given":"Rohit S.","family":"Loomba","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew N.","family":"Pelech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,9,29]]},"reference":[{"key":"S1047951116000962_ref49","first-page":"271","article-title":"Low immunoglobulin M memory B-cell percentage in patients with heterotaxy syndrome correlates with the risk of severe bacterial infection","volume":"70","author":"Chiu","year":"2015","journal-title":"Pediatr Res"},{"key":"S1047951116000962_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/021849230601400314"},{"key":"S1047951116000962_ref20","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2002.120510"},{"key":"S1047951116000962_ref40","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(95)70154-0"},{"key":"S1047951116000962_ref35","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(05)70322-6"},{"key":"S1047951116000962_ref45","doi-asserted-by":"publisher","DOI":"10.1016\/j.exphem.2006.09.013"},{"key":"S1047951116000962_ref39","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198606193142501"},{"key":"S1047951116000962_ref37","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800780904"},{"key":"S1047951116000962_ref27","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1016\/S0022-5223(19)35261-4","article-title":"The modified Fontan operation for asplenia and polysplenia syndromes","volume":"96","author":"Humes","year":"1988","journal-title":"J Thorac Cardiovasc Surg"},{"key":"S1047951116000962_ref22","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.75.3.314"},{"key":"S1047951116000962_ref3","first-page":"1","article-title":"The nomenclature, definition and classification of cardiac structures in the setting of heterotaxy","volume":"17","author":"Jacobs","year":"2007","journal-title":"Cardiol Young"},{"key":"S1047951116000962_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)80243-4"},{"key":"S1047951116000962_ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-015-1492-x"},{"key":"S1047951116000962_ref42","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198010023031401"},{"key":"S1047951116000962_ref38","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199904000-00050"},{"key":"S1047951116000962_ref46","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2257.1990.tb00037.x"},{"key":"S1047951116000962_ref5","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2069.84665"},{"key":"S1047951116000962_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(95)70208-3"},{"key":"S1047951116000962_ref16","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12288"},{"key":"S1047951116000962_ref12","first-page":"1","article-title":"Thrombocytosis in the setting of isomerism and a functionally univentricular heart","volume":"7","author":"Loomba","year":"2015","journal-title":"Cureus"},{"key":"S1047951116000962_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/ajcp\/58.2.127"},{"key":"S1047951116000962_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951105211320"},{"key":"S1047951116000962_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.06.009"},{"key":"S1047951116000962_ref44","doi-asserted-by":"publisher","DOI":"10.1136\/gut.7.2.140"},{"key":"S1047951116000962_ref17","first-page":"1281","article-title":"Arrhythmias in adult congenital patients with bodily isomerism","volume":"37","author":"Loomba","year":"2015","journal-title":"Pediatr Cardiol"},{"key":"S1047951116000962_ref34","doi-asserted-by":"publisher","DOI":"10.1007\/s100240010145"},{"key":"S1047951116000962_ref21","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1542\/peds.65.3.633","article-title":"Familial asplenia, other malformations, and sudden death","volume":"65","author":"Katcher","year":"1980","journal-title":"Pediatrics"},{"key":"S1047951116000962_ref47","first-page":"161","article-title":"Evaluation of spleen in children with heterotaxia and congenital heart disease. Tennessee medicine","volume":"97","author":"Combs","year":"2004","journal-title":"J Tenn Med Assoc"},{"key":"S1047951116000962_ref36","first-page":"285","article-title":"Postsplenectomy sepsis","volume":"1","author":"Singer","year":"1973","journal-title":"Perspect Pediatr Pathol"},{"key":"S1047951116000962_ref19","doi-asserted-by":"publisher","DOI":"10.1177\/2150135115601831"},{"key":"S1047951116000962_ref48","volume-title":"Red Book: 2006 Report of the Committee on Infectious Diseases","year":"2006"},{"key":"S1047951116000962_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70183-1"},{"key":"S1047951116000962_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2016.01.003"},{"key":"S1047951116000962_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951115001122"},{"key":"S1047951116000962_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.07.053"},{"key":"S1047951116000962_ref24","doi-asserted-by":"publisher","DOI":"10.1186\/1749-8090-8-93"},{"key":"S1047951116000962_ref30","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(77)80365-X"},{"key":"S1047951116000962_ref6","first-page":"1","article-title":"Determining bronchial morphology for the purposes of segregating so-called heterotaxy","volume":"26","author":"Loomba","year":"2015","journal-title":"Cardiol Young"},{"key":"S1047951116000962_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2013.08.051"},{"key":"S1047951116000962_ref15","doi-asserted-by":"publisher","DOI":"10.1177\/1753465816636810"},{"key":"S1047951116000962_ref8","first-page":"1","article-title":"Radiologic considerations in heterotaxy: the need for detailed anatomic evaluation","volume":"8","author":"Loomba","year":"2016","journal-title":"Cureus"},{"key":"S1047951116000962_ref14","first-page":"1","article-title":"Arterial desaturation due to pulmonary arteriovenous malformations after the Kawashima","volume":"9","author":"Loomba","year":"2015","journal-title":"Ann Pediatr Cardiol"},{"key":"S1047951116000962_ref23","doi-asserted-by":"publisher","DOI":"10.1097\/00000433-199903000-00014"},{"key":"S1047951116000962_ref4","first-page":"e269","article-title":"Fetal magnetic resonance imaging of malformations associated with heterotaxy","volume":"7","author":"Loomba","year":"2015","journal-title":"Cureus"},{"key":"S1047951116000962_ref43","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.me.14.020163.002025"},{"key":"S1047951116000962_ref29","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2009.11.048"},{"key":"S1047951116000962_ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-010-9764-z"},{"key":"S1047951116000962_ref33","doi-asserted-by":"publisher","DOI":"10.1053\/jinf.2001.0904"},{"key":"S1047951116000962_ref41","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199201303260501"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951116000962","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,9]],"date-time":"2022-07-09T07:18:59Z","timestamp":1657351139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951116000962\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,9,29]]},"references-count":49,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["S1047951116000962"],"URL":"https:\/\/doi.org\/10.1017\/s1047951116000962","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,9,29]]},"assertion":[{"value":"\u00a9 Cambridge University Press 2016\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}