Infections after cardiac surgery
Abstract number: R2438
Ezpeleta C., Alava J.A., Gómez E., Busto C., Atutxa I., Unzaga J., Cisterna R.
Objective: the aim of this study is to know the rates of NI (Nosocomial Infection) in patients operated on open heart surgery: valve replacement and by-pass grafting.
Patients and Methods: The 1871 patients operated on open-heart surgery in the hospital of Basurto between January 2000 & September 2007 were included. Preoperative protocol regarding infection control includes: shower with 4% chlorhexidine soap the night before surgery and repeated the day of surgery. Shave just before surgery. Antibiotic prophylaxis: Cefuroxime 1.5 gr. IV beginning 5 minutes before anaesthesia induction. A second intraoperative dose is administered if the operation lasts for longer than 6 hours, large estimated blood loss or fluid administration, since January 2006. The infection control team makes infection surveillance. All the patients undergoing open-heart surgery are prospectively studied since the day they are operated until the end of the episode. A computer based surveillance system INOZ designed for incidence studies of NI is used during admission and continued 1 year after discharge. CDC definitions of nosocomial infection are used. All the nosocomial infections not only surgical site infections (SSI) are recorded.
Results: Age and sex: 1270 (67.87%) men, mean age 66.4 years. Mean preoperative stay in the hospital 5.2 days (SD: 8.5). NNIS (National Nosocomial Infection Surveillance) score 0: 126 patients, score 1: 1200 patients, score 2: 527 patients and score 3: 18 patients. Nosocomial infections: 374 patients acquired 535 NI, 91 of them were Surgical Site Infections (SSI): 26 incisional superficial, 28 deep incisional and 37 organ space. NNISS score 0: 1.6%, score 1: 3.7%, score 2: 6.6% and score 3: 38.9%. Microorganisms: S. aureus 11, Coagulase-negative Staphylococci (CNS) 32. P. aeruginosa 10, Enterococcus spp. 5. Urinary tract infections (UTI): 136. E. coli (45), E. faecalis (26), P. aeruginosa 18 and C. albicans (16) were the most frequent aetiological agents. Respiratory infections: 178 patients. Pneumonia: 37 cases. Bacteraemia: 46 cases: 8 catheter related (S. aureus 3), 21 secondary (P. aeruginosa 5, E. coli 4) and 17 primary bacteraemias (Enterococcus spp. 5).
Conclusions: Cumulated incidence of SSI dropped from 5.86% to 2.70% after the introduction of the second intraoperative dose of antibiotic prophylaxis. Coagulase-negative Staphylococci are the most common bacteria isolated from Surgical Site Infections following cardiac surgery during the study period.
|Session name:||18th European Congress of Clinical Microbiology and Infectious Diseases|
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