scholarly journals Oral health and incidence of nosocomial infection and mortality in patients undergoing elective cardiac surgery

2021 ◽  
Vol 10 (5) ◽  
pp. e14910514658
Author(s):  
Gabriela Margraf Gehring ◽  
Mario Augusto Cray da Costa ◽  
Renan Bordini Cardoso ◽  
Ana Carolina Mello Fontoura de Souza ◽  
Marcelo Carlos Bortoluzzi
Keyword(s):  
Cardiac Surgery ◽  
Oral Health ◽  
Nosocomial Infection ◽  
Surgical Site Infection ◽  
Statistical Significance ◽  
Oral Disease ◽  
Hospital Death ◽  
Site Infection ◽  
Elective Cardiac Surgery ◽  
Significant Difference

Objective: To analyze the relationship between oral disease and the risk of developing hospital pneumonia, mediastinitis, endocarditis, surgical site infection and hospital death in patients undergoing elective cardiac surgery. Assess which risk factors would be related to the risk of nosocomial infection and death after cardiac surgery. Methodology: It was an analytical, observational, prospective study, carried out from January to December 2018. The study included 46 patients candidates for elective cardiac surgery and evaluated as to the type of heart disease, type of surgery, associated comorbidities, age, NYHA classification, BMI, ICU stay days, oral health assessment by a dental surgeon, occurrence of infection and hospital death. The analysis was done through analysis of absolute and relative frequencies, estimation of odds ratios, chi-square test and Mann-Whitney test. Results: Of the 46 patients analyzed, 11 (23.9%) of them had hospital infections and 4 (8.7%) died, there was no statistically significant difference in the variables studied with the occurrence of infection or death. The heterogeneity of the findings in the oral evaluation that ranged from edentulous patients with partial or total dentures, partial edentulous with or without prosthesis and varying degrees of oral disease that ranged from gingivitis, periodontitis to abscesses. The prostheses had varying degrees of conservation and hygiene. This great variability of findings may have implied no statistical significance in the variables. Conclusion: There was no statistical difference in the occurrence of hospital pneumonia, mediastinitis, endocarditis, surgical site infection and hospital death according to the patients' oral health condition.

Surgical Site Infection Rate Drops to 0% Using a Vacuum-Assisted Closure in Contaminated/ Dirty Infected Laparotomy Wounds

2017 ◽  
Vol 83 (5) ◽  
pp. 512-514 ◽  
Author(s):  
Gerardo Lozano-Balderas ◽  
Alejandro Ruiz-Velasco-Santacruz ◽  
Jose Antonio Diaz-Elizondo ◽  
Juan Antonio Gomez-Navarro ◽  
Eduardo Flores-Villalba
Keyword(s):  
Surgical Site Infection ◽  
Infection Rate ◽  
Primary Closure ◽  
Statistical Significance ◽  
Site Infection ◽  
Class Iii ◽  
Infection Rates ◽  
Vacuum Assisted Closure ◽  
Significant Difference ◽  
Delayed Closure

Wound site infections increase costs, hospital stay, morbidity, and mortality. Techniques used for wounds management after laparotomy are primary, delayed primary, and vacuum-assisted closures. The objective of this study is to compare infection rates between those techniques in contaminated and dirty/ infected wounds. Eighty-one laparotomized patients with Class III or IV surgical wounds were enrolled in a three-arm randomized prospective study. Patients were allocated to each group with the software Research Randomizer® (Urbaniak, G. C, & Plous, S., Version 4.0). Presence of infection was determined by a certified board physician according to Centers for Disease Control's Criteria for Defining a Surgical Site Infection. Twenty-seven patients received primary closure, 29 delayed primary closure, and 25 vacuum-assisted closure, with no exclusions for analysis. Surgical site infection was present in 10 (37%) patients treated with primary closure, 5 (17%) with primary delayed closure, and 0 (0%) patients receiving vacuum-assisted closure. Statistical significance was found between infection rates of the vacuum-assisted group and the other two groups. No significant difference was found between the primary and primary delayed closure groups. The infection rate in contaminated/dirty-infected laparotomy wounds decreases from 37 and 17 per cent with a primary and delayed primary closures, respectively, to 0 per cent with vacuum-assisted systems.

Indices of Surgical Site Infection Risk and Prediction of Other Adverse Outcomes During Hospitalization

2006 ◽  
Vol 27 (08) ◽  
pp. 825-828 ◽  
Author(s):  
Miguel Delgado-Rodríguez ◽  
Silvia Palma ◽  
Antonio Gómez-Ortega ◽  
Gabriel Martínez-Gallego ◽  
Marcelino Medina-Cuadros
Keyword(s):  
Nosocomial Infection ◽  
Surgical Site Infection ◽  
Roc Curve ◽  
Tertiary Care ◽  
Hospital Death ◽  
Consecutive Series ◽  
Care Hospital ◽  
Site Infection ◽  
Postsurgical Outcomes ◽  
Better Than

Objective.To assess which adverse postsurgical outcomes are best predicted by the Study on the Efficacy of Nosocomial Infection Control (SENIC) index and the National Nosocomial Infection Surveillance system (NNIS) index.Design.Prospective cohort study.Setting.The service of general surgery at a tertiary care hospital.Patients.A consecutive series of patients hospitalized for more than 1 day (n= 2,989).Results.The outcome best predicted by the SENIC and NNIS indices was assessed by estimating the area under the receiver operating characteristic (ROC) curve. The areas under the ROC curves for nosocomial infection and in-hospital death were higher for the NNIS index than they were for the SENIC index (P<.05). The NNIS index predicted in-hospital death better than it predicted surgical site infection (area under the ROC curve ± SE, 0.836 ± 0.022 vs 0.689 ± 0.017;P= .001).Conclusions.The NNIS index is superior to the SENIC index for all adverse postsurgical outcomes. Its ability to predict in-hospital mortality is clearly better than its ability to predict surgical site infection.

Indices of Surgical Site Infection Risk and Prediction of Other Adverse Outcomes During Hospitalization

2006 ◽  
Vol 27 (8) ◽  
pp. 825-828
Author(s):  
Miguel Delgado-Rodríguez ◽  
Silvia Palma ◽  
Antonio Gómez-Ortega ◽  
Gabriel Martínez-Gallego ◽  
Marcelino Medina-Cuadros
Keyword(s):  
Nosocomial Infection ◽  
Surgical Site Infection ◽  
Roc Curve ◽  
Tertiary Care ◽  
Hospital Death ◽  
Consecutive Series ◽  
Care Hospital ◽  
Site Infection ◽  
Postsurgical Outcomes ◽  
Better Than

Objective.To assess which adverse postsurgical outcomes are best predicted by the Study on the Efficacy of Nosocomial Infection Control (SENIC) index and the National Nosocomial Infection Surveillance system (NNIS) index.Design.Prospective cohort study.Setting.The service of general surgery at a tertiary care hospital.Patients.A consecutive series of patients hospitalized for more than 1 day (n = 2,989).Results.The outcome best predicted by the SENIC and NNIS indices was assessed by estimating the area under the receiver operating characteristic (ROC) curve. The areas under the ROC curves for nosocomial infection and in-hospital death were higher for the NNIS index than they were for the SENIC index (P<.05). The NNIS index predicted in-hospital death better than it predicted surgical site infection (area under the ROC curve ± SE, 0.836 ± 0.022 vs 0.689 ± 0.017; P = .001).Conclusions.The NNIS index is superior to the SENIC index for all adverse postsurgical outcomes. Its ability to predict in-hospital mortality is clearly better than its ability to predict surgical site infection.

Abstract 14873: Is There Difference in Clinical Outcomes Following Percutaneous Coronary Intervention (PCI) for Acute Coronary Syndrome (ACS) between Hospitals With and Without Onsite Cardiac Surgery Backup?

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Tomonori Akasaka ◽  
Seiji Hokimoto ◽  
Noriaki Tabata ◽  
Kenji Sakamoto ◽  
Kenichi Tsujita ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Clinical Outcomes ◽  
Primary Endpoint ◽  
Proportional Hazards Model ◽  
Cox Proportional Hazards Model ◽  
Bleeding Complications ◽  
Hospital Death ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
The Impact

Background: Based on 2011 ACCF/AHA/SCAI PCI guideline, it is recommended that PCI should be performed at hospital with onsite cardiac surgery. But, recent data suggests that there is no significant difference in clinical outcomes following primary or elective PCI between hospitals with and without onsite cardiac surgery. The proportion of PCI centers without onsite cardiac surgery comprises approximately more than half of all PCI centers in Japan. We examined the impact of with or without onsite cardiac surgery on clinical outcomes following PCI to ACS. Methods: From Aug 2008 to March 2011, subjects (n=2288) were enrolled from the Kumamoto Intervention Conference Study (KICS), which is a multicenter registry, and enrolling consecutive patients undergoing PCI in 15 centers in Japan. Patients were assigned to two groups treated in hospitals with (n=1954) or without (n=334) onsite cardiac surgery. Clinical events were followed up for 12 months. Primary endpoint was in-hospital death, cardiovascular death, myocardial infarction, and stroke. And we monitored other events those were non-cardiovascular deaths, bleeding complications, revascularizations, and emergent CABG. Results: There was no overall significant difference in primary endpoint between hospitals with and without onsite cardiac surgery (9.6%vs9.5%; P=0.737). There was also no significant difference when events in primary endpoint were considered separately. In other events, only revascularization was more frequently seen in hospitals with onsite cardiac surgery (22.1%vs12.9%; P<0.001). Kaplan-Meier analysis for primary endpoint showed that there was no significant difference between two groups (Log Rank P=0.943). By cox proportional hazards model analysis for primary endpoint, without onsite cardiac surgery was not a predictive factor for primary endpoint (HR 0.969, 95%CI 0.704-1.333; P=0.845). We performed propensity score matching analysis to correct for the disparate patient numbers between two groups, and there was also no significant difference for primary endpoint (6.9% vs 8.0%; P=0.544). Conclusions: There is no significant difference in clinical outcomes following PCI for ACS between hospitals with and without onsite cardiac surgery backup in Japan.

Chlorhexidine Showers are Associated With a Reduction in Surgical Site Infection Following Spine Surgery: An Analysis of 4266 Consecutive Surgeries

Neurosurgery ◽  
2018 ◽  
Vol 85 (6) ◽  
pp. 817-826 ◽  
Author(s):  
Andrew K Chan ◽  
Simon G Ammanuel ◽  
Alvin Y Chan ◽  
Taemin Oh ◽  
Henry C Skrehot ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Surgical Site Infection ◽  
Spine Surgery ◽  
Subgroup Analysis ◽  
Spinal Surgery ◽  
Site Infection ◽  
Safe Patient Care ◽  
Significant Difference ◽  
Additional Costs ◽  
Procedure Type

Abstract BACKGROUND Surgical site infection (SSI) is a common complication following spinal surgery. Prevention is critical to maintaining safe patient care and reducing additional costs associated with treatment. OBJECTIVE To determine the efficacy of preoperative chlorhexidine (CHG) showers on SSI rates following fusion and nonfusion spine surgery. METHODS A mandatory preoperative CHG shower protocol was implemented at our institution in November 2013. A cohort comparison of 4266 consecutive patients assessed differences in SSI rates for the pre- and postimplementation periods. Subgroup analysis was performed on the type of spinal surgery (eg, fusion vs nonfusion). Data represent all spine surgeries performed between April 2012 and April 2016. RESULTS The overall mean SSI rate was 0.4%. There was no significant difference between the pre- (0.7%) and postimplementation periods (0.2%; P = .08). Subgroup analysis stratified by procedure type showed that the SSI rate for the nonfusion patients was significantly lower in the post- (0.1%) than the preimplementation group (0.7%; P = .02). There was no significant difference between SSI rates for the pre- (0.8%) and postimplementation groups (0.3%) for the fusion cohort (P = .21). In multivariate analysis, the implementation of preoperative CHG showers were associated with significantly decreased odds of SSI (odds ratio = 0.15, 95% confidence interval [0.03-0.55], P &lt; .01). CONCLUSION This is the largest study investigating the efficacy of preoperative CHG showers on SSI following spinal surgery. In adjusted multivariate analysis, CHG showering was associated with a significant decrease in SSI following spinal surgery.

scholarly journals The Use of Oral Antibiotics to Prevent Surgical Site Infection on Postoperative Modified Radical Mastectomy Patients in Dr. Soetomo General Hospital, Surabaya

2021 ◽  
Vol 56 (1) ◽  
pp. 36
Author(s):  
Norman Hadi ◽  
Hantoro Ishardyanto
Keyword(s):  
Single Dose ◽  
Surgical Site Infection ◽  
General Hospital ◽  
Radical Mastectomy ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Site Infection ◽  
Oral Antibiotics ◽  
Modified Radical Mastectomy ◽  
Significant Difference

Surgical operations on modified radical mastectomy are considered clean procedures by the Centers for Disease Control and Prevention (CDC) wound classification system. Despite this, higher than expected Surgical Site Infection (SSI) rates are reported, varying from 1 % to 26 % across the literature. Some surgeons also prescribe postoperative prophylaxis for postoperative modified radical mastectomy patients to prevent infection despite its lack of proven efficacy. The aim of this study is to analyze the use of oral antibiotics to prevent Surgical Site Infection (SSI) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. This study was double-blinded randomized control trial of 60 postoperative modified radical mastectomy patients (2 groups) during the period of December 2017 to March 2018. Samples were prospectively divided into two groups (random sampling), in group A (n=30) patients received single dose prophylactic antibiotics and continued with oral antibiotics postoperative (Cefadroxil 2 x 500 mg) during 7 days and in group B (n=30) patients received single dose prophylactic antibiotics and continued without postoperative antibiotics (placebo). Both groups were evaluated clinically for surgical site infection up to 30 days. There was no statistically significant difference in both groups {p=1 (p>0.05)}. There was no incidence of surgical site infection in both groups during the 30-day follow-up period (days 3, 7, 14 and 30). There was no difference in the surgical site infection rate among those who received oral postoperative antibiotics prophylactic and without antibiotics (placebo) on postoperative modified radical mastectomy patients in Dr. Soetomo General Hospital. Because of the potential adverse events associated with antibiotic use, further evaluation of this practice is required.

scholarly journals Spectrum of all microorganism isolated from surgical site infection and their antimicrobial susceptibility profile

2021 ◽  
Vol 7 (4) ◽  
pp. 246-249
Author(s):  
Sudhir Singh ◽  
Mushk Bar Fatma ◽  
Umar Farooq ◽  
Vasundhara Sharma ◽  
Shweta R Sharma ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Nosocomial Infection ◽  
Surgical Site Infection ◽  
Antimicrobial Susceptibility ◽  
Cost Of Care ◽  
Site Infection ◽  
Healthcare Associated Infection ◽  
Biochemical Tests ◽  
Pathogenic Organism ◽  
Sensitivity Pattern

Surgical site infection are the most common nosocomial infection accounting for 14% healthcare associated infection and are estimated to double the post-operative stay and significantly increase the cost of care. Surgical site infection has been considered as the third regularly occurring infection according to national nosocomial infection surveillance system.To determine the bacterial agents causing surgical site infection and antimicrobial susceptibility pattern of isolated microorganisms.: Isolate and identify pathogens of surgical site infection. To determine antimicrobial resistance and sensitivity pattern of isolated wound microbes. To determine the frequency of pathogens of surgical site infection.: Samples were cultured on Blood agar and MacConkey agar then incubated at 37 C for 24 hours. Any growth for further confirmed by Gram stain and appropriate biochemical tests, and then Antibiotic sensitivity test was done.: In this study 106 (61.7) were of male and 66 (38.3) were of female total 172 were examined. In our study total 172 patients included in which 142 pathogenic organism were isolated. The most common pathogenic organism found to be 44 isolates (30.99%) followed by 41 isolates (28.87%) 23 isolates (16.20%), 18 isolates (12.68%), 9 isolates (6.34%), 5 isolates (3.52%), 1 isolate (0.70%) and 1 isolate (0.70%). Antimicrobial resistance always pose challenges for clinician for treating wound infection the present study guide clinician about common pathogens and countered in pus sample furthermore it help the clinician to select and treat patients with proper antibiotics and decreased mortality and morbidity.

scholarly journals Characterization of children submitted to cardiac surgery that developed surgical site infection

2020 ◽  
Author(s):  
Aurilene Lima da Silva ◽  
Ticiana Bezerra Castro Pontes ◽  
Maria Sinara Farias ◽  
Maria José Matias Muniz Filha ◽  
Solange Gurgel Alexandre ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Surgical Site Infection ◽  
Prophylactic Antibiotic ◽  
Site Infection ◽  
Skin Preparation ◽  
Descriptive Research ◽  
Care Processes ◽  
The City ◽  
Diagnosis Of Infection

Objective: Characterize the clinical and surgical profile of children undergoing cardiac surgery who developed surgical site infection in a public hospital in the city of Fortaleza, Ceará. Methods: Descriptive research with a quantitative approach, developed in a pediatric cardiology unit, with data collected from April to June 2018. The study sample consisted of 26 children with surgical wound infection in the year 2017. Results: There were none gender prevalence; the weight range varied from 3 to 6 kg (42.3%) and neonates had a prevalence of 38%. Corrective surgeries represented 88% of the total; the surgical time varied from 2 to 6 hours (38%); 70% of the children were submitted to cardiopulmonary bypass with the predominant time of 90 to 120 minutes (27%); the diagnosis of infection was made between 4 and 6 days after the procedure. There was prophylactic antibiotic coverage in 88% and skin preparation in 92% of children. Conclusion: Characterizing the clinical-surgical profile of children undergoing cardiac surgery becomes essential for decision-making in the care processes of nurses, emphasizing the findings as a basis for the development of strategies for the prevention of surgical site infection in this clientele.

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