Local infectious complications in cardiac surgery : etiology and the role of antimicrobial prophylaxis
OBJECTIVE: To investigate the relationship between antimicrobial prophylaxis protocol, prevalence and etiology of local infectious complications after open cardiac surgery.
MATERIAL AND METHODS: A retrospective cohort observational study was performed between 2010 and 2019 at the Ural Institute of Cardiology. Antimicrobial prophylaxis was performed using the main (cefuroxime 1.5 g IV every 6 hours) and alternative protocols (vancomycin 15 mg/kg IV every 12 hours).
RESULTS: The prevalence of local infectious complications throughout the entire follow-up period was 4.5±0.3% [95% CI 4.45-4.54]. There were 42 cases of deep infection (0.9±0.13%). Coagulase-negative staphylococci prevailed (15.9±2.5% of cases, 35 cultures). Resistant flora included coagulase-negative methicillin-resistant staphylococci (13 cultures, 37.1±8.2%) and representatives of Enterobacteriaceae family, producers of extended-spectrum beta-lactamase (8 cultures, 50.0±18.2%). Antimicrobial prophylaxis with vancomycin increases the risk of local infectious complications (OR 1.75, 95% CI 1.20, 2.55, p=0.001). Both protocols of antimicrobial prophylaxis demonstrated comparable efficacy against gram-positive and gram-negative microorganisms.
CONCLUSION: Coagulase-negative staphylococci are the most common cause of local infectious complications in cardiac surgery. Modern antimicrobial prophylaxis regimens are relevant despite resistant flora.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2022 |
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| Enthalten in: |
Khirurgiia - (2022), 6 vom: 03., Seite 40-47 |
| Sprache: |
Russisch |
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| Weiterer Titel: |
Infektsionnye oslozhneniya v oblasti khirurgicheskogo vmeshatel'stva v kardiokhirurgii: etiologiya i rol' antimikrobnoi profilaktiki |
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| Beteiligte Personen: |
Stepin, A V [VerfasserIn] |
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| Links: |
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| Themen: |
6Q205EH1VU |
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| Anmerkungen: |
Date Completed 08.06.2022 Date Revised 08.06.2022 published: Print Citation Status MEDLINE |
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| doi: |
10.17116/hirurgia202206140 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM341800554 |
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| 245 | 1 | 0 | |a Local infectious complications in cardiac surgery |b etiology and the role of antimicrobial prophylaxis |
| 246 | 3 | 3 | |a Infektsionnye oslozhneniya v oblasti khirurgicheskogo vmeshatel'stva v kardiokhirurgii: etiologiya i rol' antimikrobnoi profilaktiki |
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| 500 | |a Date Completed 08.06.2022 | ||
| 500 | |a Date Revised 08.06.2022 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: To investigate the relationship between antimicrobial prophylaxis protocol, prevalence and etiology of local infectious complications after open cardiac surgery | ||
| 520 | |a MATERIAL AND METHODS: A retrospective cohort observational study was performed between 2010 and 2019 at the Ural Institute of Cardiology. Antimicrobial prophylaxis was performed using the main (cefuroxime 1.5 g IV every 6 hours) and alternative protocols (vancomycin 15 mg/kg IV every 12 hours) | ||
| 520 | |a RESULTS: The prevalence of local infectious complications throughout the entire follow-up period was 4.5±0.3% [95% CI 4.45-4.54]. There were 42 cases of deep infection (0.9±0.13%). Coagulase-negative staphylococci prevailed (15.9±2.5% of cases, 35 cultures). Resistant flora included coagulase-negative methicillin-resistant staphylococci (13 cultures, 37.1±8.2%) and representatives of Enterobacteriaceae family, producers of extended-spectrum beta-lactamase (8 cultures, 50.0±18.2%). Antimicrobial prophylaxis with vancomycin increases the risk of local infectious complications (OR 1.75, 95% CI 1.20, 2.55, p=0.001). Both protocols of antimicrobial prophylaxis demonstrated comparable efficacy against gram-positive and gram-negative microorganisms | ||
| 520 | |a CONCLUSION: Coagulase-negative staphylococci are the most common cause of local infectious complications in cardiac surgery. Modern antimicrobial prophylaxis regimens are relevant despite resistant flora | ||
| 650 | 4 | |a Journal Article | |
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| 650 | 4 | |a antibiotic resistance | |
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| 650 | 4 | |a surgical site infection | |
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