Blood stream infection in patients undergoing systematic off-pump coronary artery bypass: Incidence, risk factors, outcome, and associated pathogens

Chen Yen Chien, Cheng Hsin Lin, Jeng Wei Chen, Ron Bin Hsu

研究成果: 雜誌貢獻文章同行評審

4 引文 斯高帕斯(Scopus)

摘要

Background: Blood stream infection (BSI) is a major cause of mortality and morbidity for patients undergoing cardiac surgery. However, information is lacking about patients undergoing off-pump coronary artery bypass (OPCAB). The purpose of this study was to assess the incidence, risk factors, outcome and associated pathogens of BSI after OPCAB.

Methods: One thousand ten consecutive patients undergoing OPCAB between 2001 and 2012 were included in a retrospective case-control study. A propensity-matched control was used for risk factor analysis.

Results: Of the 1,010 patients, 26 patients (2.6%) had 32 episodes of BSI after surgery, which occurred at a median of 14 d after surgery. Gram-negative bacilli and gram-positive cocci were distributed equally. Methicillin-resistant Staphylococcus aureus was the pathogen identified most frequently, and the most common source of infection was a surgical site. The hospital mortality rate was 54%. By univariable analysis, diabetes mellitus, pre-operative renal impairment, pre-operative low hemoglobin, pre-operative endotracheal intubation, dialysis before or after surgery, cardiogenic shock, left ventricular ejection fraction of less than 40%, non-elective surgery, low number of distal anastomoses, atrial fibrillation after surgery, and re-operation for bleeding were significant risk factors. By multivariable analysis, the independent risk factors were left ventricular ejection fraction of less than 40%, low number of distal anastomoses, atrial fibrillation after surgery, and dialysis after surgery.

Conclusions: Blood stream infections remained a common complication after OPCAB, and the mortality was high. Gram-negative bacilli and gram-positive cocci were distributed equally. Methicillin-resistant S. aureus was the pathogen identified most frequently. Preventive tactics should target likely pathogens and high-risk patients undergoing OPCAB.

原文英語
頁(從 - 到)613-618
頁數6
期刊Surgical Infections
15
發行號5
DOIs
出版狀態已發佈 - 10月 1 2014
對外發佈

ASJC Scopus subject areas

  • 手術
  • 傳染性疾病
  • 微生物學(醫學)
  • 一般醫學

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