Preview

Epidemiology and Vaccinal Prevention

Advanced search

Surgical Site Infections in Cardiac Surgery, Open-Heart Surgery Infections

https://doi.org/10.31631/2073-3046-2020-19-3-52-56

Abstract

Relevance. Cardiac surgery is a direction that is currently being actively developed. The number of operations performed on an openheart is growing annually, and the number of postoperative complications, including infectious ones, is correspondingly increasing. The purpose of the work is to identify the frequency of surgical site infections (SSI) in open-heart surgery, to study the leading risk factors, to identify possible sources of infection. Materials and methods. Basic information was obtained from medical records, as well as using the medical information system, which allows to track the patient's repeated hospitalization in the hospital, and the laboratory information system. Additional forms have been developed to account for intraoperative risk factors. The follow-up period was 3 years (2016-2018). A total of 433 surgical interventions and their outcomes were analyzed, the duration of follow-up f o r patients was 1 year from the time of surgery. Identified 19 cases of SSI. Results and discussion. The frequency of SSI in open-heart surgery was 4.4 per 100 operations (2.6-6.7). Up to 74% of all SSI occurred in the period up to 30 days from the moment of surgery. The relative risk index was calculated for such factors as the length of stay in the intensive care unit in the postoperative period, the timing of drainage of the postoperative wound, and diabetes mellitus. It has been established that for cardiosurgical operations on the 1st class of wounds, diabetes mellitus is a significant risk factor for SSI. The analysis pathogens in patients with acute respiratory infections and the microbiological landscape of the departments made it possible to establish cases of possible infection of patients in the hospital, and in some cases put forward an assumption of endogenous infection. Conclusions. An epidemiological investigation, the development, and implementation of anti-epidemic measures require a complete consideration of possible risk factors, the participation of cardiac surgeons in identifying, and analyzing each case of SSI, and the mandatory exchange of information about the outcome of the disease between medical organizations that are involved in the management of a cardiac surgical patient in the postoperative period.

About the Authors

E. R. Tsoy
City Mariinsky Hospital
Russian Federation

Ekaterina R. Tsoy - epidemiologist at City Mariinsky Hospital.

56 Liteyny prospert, St. Petersburg, 191104.

+7(812)2757460


L. P. Zueva
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Ludmila P. Zueva - Dr. Sci. (Med.), Professor, Head of the Department of Epidemiology, Parasitology and Disinfection at North-western State Medical University named after I.I. Mechnikov.

41 Kirochnaya str., St. Petersburg, 191015.

+7(812) 543-02-41


S. M. Mikaelyan
City Mariinsky Hospital
Russian Federation

Siranush M. Mikaelyan - epidemiologist, City Mariinsky Hospital.

56 Liteyny prospert, St. Petersburg, 191104.

+7(812)275-74-60


B. M. Taits
North-Western State Medical University named after I.I. Mechnikov
Russian Federation

Boris M. Taits - Dr. Sci. (Med.), Professor, Head of the Department, Public Health and Health Management at North-western State Medical University named after I.I. Mechnikov.

41 Kirochnaya str., St. Petersburg, 191015.

+7(812)303-50-00


References

1. Aref'eva LI, Gorskaya EM, Savostyanova OA. et al. Infectious complications of a bacterial nature in cardiovascular surgery. Russian Medical Journal. 2013;3:36-42. (In Russ).

2. Khubulava GG, Shikhverdiyev NN, Vogt PR, et al. Results of the application of the method of elimination of sternal infection in cardiosurgical patients.Bulletin of Surgery. 2015;174(5):57-60. (In Russ).

3. Shikhverdiev NN, Khubulava GG, Marchenko SP, et al. Intraoperative use of antibiotics for the prevention of sternal infection in cardiac surgery. Circulatory pathology and cardiac surgery. 2017;21(1):69-72. (In Russ).

4. Kuznetsov MS, Kozlov BN, Nasrashvili DS, et al. Comparative analysis of the results of the application of methods for elimination of sternal infection in cardiac surgery. Journal named after academician B.V. Petrovsky. 2016;2:51-59. (In Russ).

5. Chernyavsky AM, Tarkova AR, Ruzmatov TM, et al. Infections in cardiac surgery. Surgery. 2016;5:64-68. (In Russ).

6. Bockeria LA, Beloborodova NV. Infections in Cardiac Surgery. A. N. Bakulev National Medical Research Center of Cardiovascular Surgery. Moscow. 2007:582 p. (In Russ).

7. Khubulava GG, Shikhverdiev NN, Vogt PR, et al. Prediction of the likelihood of developing sternal infection in cardiac patients. Issues of general and private surgery. 2018;177(1):11-15. (In Russ)

8. Khubulava GG, Shikhverdiyev NN, Naumov AB, et al. Pathophysiological mechanisms and risk factors for the development of sternal infection in cardiac surgery. Bulletin of the Russian Military Medical Academy. 2013;1(41):174-179. (In Russ).

9. Bogomolova NS, Kuznetsova SM, Bolshakov LV. The role of microbiological monitoring and medical history in the effectiveness of antibiotic prophylaxis and antibiotic therapy of infectious complications after reconstructive surgery / Anesthesiology and intensive care. 2015;2:20-26. (In Russ).

10. Sotnikov AV, Melnikov MV, Elmadzhi RV, et al. On the prevention of mediastinitis in cardiac patients. HERALD of North-Western State Medical University named after I.I. Mechnikov. 2015;7(4):38-42. (In Russ).


Review

For citations:


Tsoy E.R., Zueva L.P., Mikaelyan S.M., Taits B.M. Surgical Site Infections in Cardiac Surgery, Open-Heart Surgery Infections. Epidemiology and Vaccinal Prevention. 2020;19(3):52-56. (In Russ.) https://doi.org/10.31631/2073-3046-2020-19-3-52-56

Views: 1174


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2073-3046 (Print)
ISSN 2619-0494 (Online)