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Surgical-Site Infection After Cardiac Surgery: Incidence, Microbiology, and risk Factors

Published online by Cambridge University Press:  21 June 2016

Didier Lepelletier ,
Stéphanie Perron ,
Philippe Bizouarn ,
Jocelyne Caillon ,
Henri Drugeon ,
Jean-Luc Michaud  and
Daniel Duveau
Didier Lepelletier*
Affiliation:
Bacteriology and Infection Control Laboratory and the Department of Cardiac Surgery, Laennec Hospital, Nantes, France
Stéphanie Perron
Affiliation:
Bacteriology and Infection Control Laboratory and the Department of Cardiac Surgery, Laennec Hospital, Nantes, France
Philippe Bizouarn
Affiliation:
Bacteriology and Infection Control Laboratory and the Department of Cardiac Surgery, Laennec Hospital, Nantes, France
Jocelyne Caillon
Affiliation:
Bacteriology and Infection Control Laboratory and the Department of Cardiac Surgery, Laennec Hospital, Nantes, France
Henri Drugeon
Affiliation:
Bacteriology and Infection Control Laboratory and the Department of Cardiac Surgery, Laennec Hospital, Nantes, France
Jean-Luc Michaud
Affiliation:
Bacteriology and Infection Control Laboratory and the Department of Cardiac Surgery, Laennec Hospital, Nantes, France
Daniel Duveau
Affiliation:
Bacteriology and Infection Control Laboratory and the Department of Cardiac Surgery, Laennec Hospital, Nantes, France
*
Laboratory of Bacteriology and Infection Control, Hôpital Laënnec, Boulevard J Monod, St Herblain, 44 000 Nantes, France[email protected]
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Abstract

Objective:

To identify risk factors associated with surgical-site infection according to the depth of infection, the cardiac procedure, and the National Nosocomial Infections Surveillance System risk index.

Design:

Prospective survey conducted during a 12-month period.

Setting:

A 48-bed cardiac surgical department in a teaching hospital.

Patients:

Patients admitted for cardiac surgery between February 2002 and January 2003.

Results:

Surgical-site infections were diagnosed in 3% of the patients (38 of 1,268). Of the 38 surgical-site infections, 20 were superficial incisional infections and 18 were mediastinitis for incidence rates of 1.6% and 1.4%, respectively. Cultures were positive in 28 cases and the most commonly isolated pathogen was Staphylococcus. A National Nosocomial Infections Surveillance System risk index score of 2 or greater was associated with a risk of surgical-site infection (relative risk, 2.4; P < .004). Heart transplantation, mechanical circulatory assistance, coronary artery bypass graft with the use of internal mammary artery, and reoperation for cardiac tamponade or pericard effusion were independent risk factors associated with surgical-site infection.

Conclusions:

Data surveillance using incidence rates stratified by cardiac procedure and type of infection is relevant to improving infection control efforts. Risk factors in patients who developed superficial infection were different from those in patients who developed mediastinitis. Coronary artery bypass graft using internal mammary artery was associated with a high risk of surgical-site infection, and independent factors such as reoperation for cardiac tamponade or pericard effusion increased the risk of infection.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 26 , Issue 5 , May 2005 , pp. 466 - 472
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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