Sternal Surgical-Site Infection Following Coronary Artery Bypass Graft Prevalence, Microbiology, and Complications During a 42-Month Period
| Autor: | Mamta Sharma, Dorine Berriel-Cass, Joseph Baran |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Male
Microbiology (medical) Michigan Staphylococcus aureus Sternum medicine.medical_specialty Time Factors Epidemiology Bacteremia Hospitals Community medicine.disease_cause Medical Records Microbiology Prevalence medicine Humans Surgical Wound Infection Derivation Coronary Artery Bypass Hospitals Teaching Aged Aged 80 and over Cross Infection business.industry Medical record Surgical wound Middle Aged medicine.disease Surgery Logistic Models Infectious Diseases medicine.anatomical_structure Female Complication business Sentinel Surveillance Artery |
| Zdroj: | Infection Control & Hospital Epidemiology. 25:468-471 |
| ISSN: | 1559-6834 0899-823X 0195-9417 |
| DOI: | 10.1086/502423 |
| Popis: | Objective:Surgical-site infection (SSI) is a serious and costly complication following coronary artery bypass graft (CABG). We analyzed surgical factors, microbiology, and complications at a 608-bed community teaching hospital to identify opportunities for prevention.Methods:All patients undergoing CABG procedures from June 1997 through December 2000 were analyzed. Hospital records and postdischarge surveillance data were reviewed for demographics, surgical information, timing and classification of infection, microbiology, and bacteremic events.Results:Of 3,443 patients undergoing CABG, sternal SSI developed in 122 (3.5%); 71 (58.2%) were classified as superficial SSI and 51 (41.8%) as deep SSI. Surgical antimicrobial prophylaxis was employed in all cases. On average, infection occurred 21.5 days (range, 4 to 315) after CABG. Most cases were diagnosed on readmission (59%); 20 cases (16%) were identified by postdischarge surveillance. Microbiological data were positive in 109 (89.3%), with a single pathogen implicated in most (86.2%). Gram-positive cocci were most frequently recovered (81%); gram-negative bacilli (17%), gram-positive bacilli (1%), and yeast (1%) were less common.Staphylococcus aureuswas the most frequently isolated pathogen (49%). Bacteremia was noted in 22 instances (18%). It was significantly associated with deep SSI (P=. 002) and identified only inS. aureuscases.Conclusions:SSI complicated 3.5% of the procedures.S. aureuswas implicated in most of the cases and was significantly associated with deep SSI. It was the only pathogen associated with secondary bacteremia. In addition to standard guidelines, targeted methods againstS. aureusshould help reduce the overall rate of SSI. |
| Databáze: | OpenAIRE |
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