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Epidemiology and outcome of major postoperative infections following cardiac surgery: risk factors and impact of pathogen type.

Publication ,  Journal Article
Chen, LF; Arduino, JM; Sheng, S; Muhlbaier, LH; Kanafani, ZA; Harris, AD; Fraser, TG; Allen, K; Corey, GR; Fowler, VG
Published in: Am J Infect Control
December 2012

BACKGROUND: Major postoperative infections (MPIs) are poorly understood complications of cardiac surgery. We examined the epidemiology, microbiology, and outcome of MPIs occurring after cardiac surgery. METHODS: The study cohort was drawn from the Society of Thoracic Surgeon National Cardiac Database and comprised adults who underwent cardiac surgery at 5 tertiary hospitals between 2000 and 2004. We studied the incidence, microbiology, and risk factors of MPI (bloodstream or chest wound infections within 30 days after surgery), as well as 30-day mortality. We used multivariate regression analyses to evaluate the risk of MPI and mortality. RESULTS: MPI was identified in 341 of 10,522 patients (3.2%). Staphylococci were found in 52.5% of these patients, gram-negative bacilli (GNB) in 24.3%, and other pathogens in 23.2%. High body mass index, previous coronary bypass surgery, emergency surgery, renal impairment, immunosuppression, cardiac failure, and peripheral/cerebrovascular disease were associated with the development of MPI. Median postoperative duration of hospitalization (15 days vs 6 days) and mortality (8.5% vs 2.2%) were higher in patients with MPIs. Compared with uninfected individuals, odds of mortality were higher in patients with S aureus MPIs (adjusted odds ratio, 3.7) and GNB MPIs (adjusted odds ratio, 3.0). CONCLUSIONS: Staphylococci accounted for the majority of MPIs after cardiac surgery. Mortality was higher in patients with Staphylococcus aureus- and GNB-related MPIs than in patients with MPIs caused by other pathogens and uninfected patients. Preventive strategies should target likely pathogens and high-risk patients undergoing cardiac surgery.

Duke Scholars

Published In

Am J Infect Control

DOI

EISSN

1527-3296

Publication Date

December 2012

Volume

40

Issue

10

Start / End Page

963 / 968

Location

United States

Related Subject Headings

  • Thoracic Surgery
  • Survival Analysis
  • Surgical Wound Infection
  • Sepsis
  • Risk Factors
  • Retrospective Studies
  • Middle Aged
  • Male
  • Incidence
  • Humans
 

Citation

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ICMJE
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Chen, L. F., Arduino, J. M., Sheng, S., Muhlbaier, L. H., Kanafani, Z. A., Harris, A. D., … Fowler, V. G. (2012). Epidemiology and outcome of major postoperative infections following cardiac surgery: risk factors and impact of pathogen type. Am J Infect Control, 40(10), 963–968. https://doi.org/10.1016/j.ajic.2012.01.012
Chen, Luke F., Jean Marie Arduino, Shubin Sheng, Lawrence H. Muhlbaier, Zeina A. Kanafani, Anthony D. Harris, Thomas G. Fraser, Keith Allen, G Ralph Corey, and Vance G. Fowler. “Epidemiology and outcome of major postoperative infections following cardiac surgery: risk factors and impact of pathogen type.Am J Infect Control 40, no. 10 (December 2012): 963–68. https://doi.org/10.1016/j.ajic.2012.01.012.
Chen LF, Arduino JM, Sheng S, Muhlbaier LH, Kanafani ZA, Harris AD, et al. Epidemiology and outcome of major postoperative infections following cardiac surgery: risk factors and impact of pathogen type. Am J Infect Control. 2012 Dec;40(10):963–8.
Chen, Luke F., et al. “Epidemiology and outcome of major postoperative infections following cardiac surgery: risk factors and impact of pathogen type.Am J Infect Control, vol. 40, no. 10, Dec. 2012, pp. 963–68. Pubmed, doi:10.1016/j.ajic.2012.01.012.
Chen LF, Arduino JM, Sheng S, Muhlbaier LH, Kanafani ZA, Harris AD, Fraser TG, Allen K, Corey GR, Fowler VG. Epidemiology and outcome of major postoperative infections following cardiac surgery: risk factors and impact of pathogen type. Am J Infect Control. 2012 Dec;40(10):963–968.
Journal cover image

Published In

Am J Infect Control

DOI

EISSN

1527-3296

Publication Date

December 2012

Volume

40

Issue

10

Start / End Page

963 / 968

Location

United States

Related Subject Headings

  • Thoracic Surgery
  • Survival Analysis
  • Surgical Wound Infection
  • Sepsis
  • Risk Factors
  • Retrospective Studies
  • Middle Aged
  • Male
  • Incidence
  • Humans