Evaluation of nosocomial infections following cardiovascular surgery

Abstract

Objective: To evaluate nosocomial infections (NI) following cardiovascular surgery (CVS), and to share the first seven-year experience of the infection control commission in a private medical center. Methods: Active prospective and laboratory based surveillance program of the hospital from January 1999 to December 2005 was used and all patients who were found to have NIs after CVS during their stay or readmission were included. Results: A total of 14502 cardiovascular operations were performed and 416 (2.9%) patients had 494 NIs. The most prevalent infections were surgical site infections (42%) and urinary tract infections (22%). The most frequently isolated microorganisms were coagulase-negative staphylococci (19%), Escherichia coli (16%) and Staphylococcus aureus (16%). A total of 99 patients (24%) died. The mortality rates were high in patients with blood-stream infections (58%) and lower respiratory tract infections (37%). The 2003 was the year with the lowest NI rate when compared to 2000, 2001, 2002, 2004, and 2005 (p< 0.005). Conclusion: This study allowed an evaluation of NIs, including incidence and distribution, following CVS. While carrying on the studies to prevent NIs that are responsible for serious morbidity and mortality, risk factors also need to be identified in order to take preventive measures, other than the ones present. (Anadolu Kardiyol Derg 2007; 7: 164-8)Amaç: Kardiyovasküler cerrahi sonras› geliflen nozokomiyal enfeksiyonlar›n (NE) de¤erlendirilmesi ve özel bir hastanede infeksiyon kontrol komitesinin ilk yedi y›ll›k çal›flma sonuçlar›n›n paylafl›lmas›. Yöntemler: Aktif prospektif ve laboratuvara dayal› sürveyans çal›flmalar› ile, Ocak 1999-Aral›k 2005 tarihleri aras›nda, kardiyovasküler cerrahiyi takiben, yat›fllar› s›ras›nda ve taburcu edildikten sonra kontrole gelen hastalarda geliflen NE olgular› dahil edilmifltir. Bulgular: Toplam 14502 operasyon gerçeklefltirilmifl, 416 hastada (%2.9) 494 NE geliflmifltir. En s›k rastlan›lan enfeksiyonlar cerrahi alan enfeksiyonlar› (%42) ve üriner sistem enfeksiyonlar› (%22), en s›k rastlan›lan bakteriler de koagülaz negatif stafilokoklar (%19), Escherichia coli (%16) ve Staphylococcus aureus (%16) olarak bulunmufltur. Nozokomiyal enfeksiyon geliflen hastalar›n %24’ü eksitus olmufltur. Mortalite oran› dolafl›m sistemi enfeksiyonlar›nda %58, alt solunum yollar› enfeksiyonlar›nda %37 olarak bulunmufltur. 2003 y›l›, 2000, 2001, 2002, 2004 ve 2005 y›llar› ile karfl›laflt›r›ld›¤›nda NE oran› en düflük y›l olmufltur (p<0.005). Sonuç: Bu çal›flma ile, insidans ve da¤›l›m dahil, kardiyovasküler cerrahi sonras› geliflen nozokomiyal enfeksiyonlar de¤erlendirilmifltir. Ciddi morbidite ve mortaliteye yol açan NE önleme çal›flmalar›na devam edilmesi, mevcut olanlar d›fl›nda gerekli önlemlerin al›nabilmesi amac›yla risk faktörlerinin de ortaya konulmas›n›n uygun olaca¤› kanaatine var›lm›flt›r. (Anadolu Kardiyol Derg 2007; 7: 164-8)