Healthcare-associated infections in the postoperative period after cardiac surgery

Authors

  • Edivete Regina Andrioli Escola Paulista de Medicina, Universidade Federal de São Paulo
  • Rubens Andrioli Cavalheiro Real e Benemérita Associação Portuguesa de Beneficência de São Paulo
  • Guilherme Campos Furtado Escola Paulista de Medicina, Universidade Federal de São Paulo
  • Walter José Gomes Escola Paulista de Medicina, Universidade Federal de São Paulo
  • Eduardo Alexandrino Medeiros Escola Paulista de Medicina, Universidade Federal de São Paulo

DOI:

https://doi.org/10.3396/ijic.v14i1.17770

Abstract

Background: This study aimed to determine the incidence of healthcare-associated infections (HAIs) in patients undergoing cardiac surgery, analyzing data and clinical outcomes in patients with and without HAIs. Methods: This was a prospective cohort study involving 293 consecutive adult patients undergoing cardiac surgery between April 2011 and October 2012. Results: Of the 293 patients, 60 (24.9%) developed 73 HAIs: 24 surgical site infections, 24 pneumonias, 14 urinary tract infections (UTIs), and 11 bloodstream infections (BSIs). The incidence of ventilator-associated pneumonia was 14.6 cases/1,000 ventilator-days, whereas that of catheter-associated UTI was 7.15 cases/1,000 catheter-days and that of central line-associated BSI was 4.52 cases/1,000 central line-days. Of the 60 patients with HAIs, 20 (33%) died before postoperative day 90, compared with 18 (7.7%) of the 233 patients without HAIs (P < .001). Independent variables associated with infection were length of hospital stay (OR, 1.04; 95% CI, 1.01-1.06; P = .002), duration of urinary catheter use (OR, 1.19; 95% CI, 1.07-1.13; P = .001), and duration of central line use (OR, 1.07; 95% CI, 1.01-1.13; P = .032). Independent variables associated with mortality were Acute Physiology and Chronic Health Evaluation II score (OR, 1.27; 95% CI 1.14-1.42; P < .001), pneumonia (OR, 11.94; 95% CI, 3.83-37.17; P < .001), UTI (OR, 8.59; 95% CI, 1.91-38.7; P = .005), and BSI (OR, 6.16; 95% CI, 1.08-34.98; P = .040). Conclusion: Among the most important complications after cardiac surgery are HAIs. Patients who experience postoperative infections have increased length of hospital stay and mortality.

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Author Biographies

Edivete Regina Andrioli, Escola Paulista de Medicina, Universidade Federal de São Paulo

Division of Infectious Diseases

Rubens Andrioli Cavalheiro, Real e Benemérita Associação Portuguesa de Beneficência de São Paulo

Department of Cardiovascular Surgery

Guilherme Campos Furtado, Escola Paulista de Medicina, Universidade Federal de São Paulo

Division of Infectious Diseases

Walter José Gomes, Escola Paulista de Medicina, Universidade Federal de São Paulo

Division of Cardiovascular Surgery

Eduardo Alexandrino Medeiros, Escola Paulista de Medicina, Universidade Federal de São Paulo

Division of Infectious Diseases

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Published

2018-03-28

How to Cite

Andrioli, E. R., Cavalheiro, R. A., Furtado, G. C., Gomes, W. J., & Medeiros, E. A. (2018). Healthcare-associated infections in the postoperative period after cardiac surgery. International Journal of Infection Control, 14(1). https://doi.org/10.3396/ijic.v14i1.17770

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Section

Original Articles