Surgical site infection after open heart surgery
Abstract number: P1459
Ezpeleta C., Gomez E., Unzaga M.J., Atucha I., Alava J.A., Arias A., Cisterna R.
Objective: To know the rates of NI (Nosocomial Infection) and surgical site infections (SSI) in patients operated on open heart surgery in our hospital and to compare with those of HELICS (Hospital in Europe Link for Infection Control trough surveillance).
Patients and Methods: The 2422 patients (pt) operated on open-heart surgery in our hospital from Jan 2000 to Oct 2009 were included. Preoperative protocol regarding infection control includes: shower with 4% clorhexidine soap the night before surgery and repeated the day of surgery. Hair clipping just before surgery. Antibiotic prophylaxis: Cefuroxime 1.5 gr. IV 5 minutes before surgery. A second dose is administrated intraoperatively if the length of surgery is >6 hours or hemodilution >15 ml/kg or blood loss >1.5 l. All the pt are prospectively studied since the day they are operated until the end of the episode by the infection control team during admission and continued 1 year after discharge. Variables under surveillance are age, sex, underlying illnesses, predisposing conditions, ASA, NNIS risk index, antibiotic prophylaxis, nosocomial infections, microorganisms, length of hospital stay, treatment and outcome. CDC definitions of nosocomial infection are used.
Results: 1630 men, mean age 66.6 y. Nosocomial infections: 487 pt acquired 708 NI, 127 of them were surgical site infections (SSI), Respiratory 231, Urinary tract 187, local catheter site 62, bacteremia 64: primary 24, secondary 30, and catheter related 10. Cumulated incidence of pt with NI 20.11%. SSI: 32 incisional superficial, 39 deep incisional and 56 organ space. NNIS score 0: 156 pt, 1.9% SSI; Score 1: 1510 pt, 4.2% SSI; Score 2: 724 pt, 6.4% SSI, Score 3: 30 pt, 26.7% SSI. Antibiotic prophylaxis was administered in 99.5% of the cases. The dosage, time, drug and duration of the prophylaxis were appropriated (99.9%, 99.5%, 99.8% and 95.2% respectively). Microorganisms in SSI: coagulase negative Staphylococci (CNS) 45, P. aeruginosa 12, S. aureus 18 (6 SAMR). Cumulated incidence of SSI 5.24%.
Conclusions: Comparing our data of SSI (5.24%) with the latest HELICS-SSI report 2004 (1043 cases) our results are lower than the total results (10%). Gram positive cocci are the most common isolated in SSIs in our hospital, similarly in the HELICS report Gram-positive cocci are recovered in 68.4% of cases. In our case series CNS are the most frequent recovered from SSI and in the HELICS report S. aureus predominates with 31.6% of isolates.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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