Lomtadze M, Chkhaidze M, Mgeladze E, Metreveli I, Tsintsadze A
Jo Ann Medical Center, Cardiac Surgery, Cardiology Clinic, Tbilisi, Georgia.
Georgian Med News. 2010 Jan(178):7-11.
Nosocomial infections still remain a serious problem in patients undergoing open heart surgery. The aim of the study was to determine the incidence, etiology and main risk factors of nosocomial infections (NI) following cardiac surgery in congenital heart diseases population. Retrospective case study was conducted. 387 patients with congenital heart disease (CHD), who underwent cardiac surgery from January 2007 to December 2008 were studied. The age of the most patients varied between 1 day to 15 years, 73 patients (18,8%) were older than 15 years. All 387 patients underwent cardiac surgery. The rate of NI was 16%. The most common infections were bloodstream infections (BSI) (7,75%) and respiratory tract infections (7%) respectively. The rate of NI was higher in patients under 1 year of age, after urgent surgery and urgent reoperation, long cardiopulmonary bypass (CPB) and aortic cross-clamp time, also in patients with prolonged mechanical ventilation, massive haemotransfusion, with open heart bone after surgery, reintubation, hospitalization in another hospital during last three month. It was concluded that the most common nosocomial infection after cardiac surgery congenital heart diseases in Georgian population was blood stream infection. The main risk factors of NI in the same setting were age under 1 year, urgent surgery, urgent reoperation, long CPB and aortic cross-clamp time, long duration of mechanical ventilation, massive haemotransfusion, open heart bone after surgery, reintubation, hospitalization in another hospital during last three month.
医院感染仍是接受心脏直视手术患者面临的一个严重问题。本研究的目的是确定先天性心脏病患者心脏手术后医院感染（NI）的发生率、病因及主要危险因素。进行了回顾性病例研究。研究对象为2007年1月至2008年12月期间接受心脏手术的387例先天性心脏病（CHD）患者。大多数患者年龄在1天至15岁之间，73例（18.8%）患者年龄超过15岁。所有387例患者均接受了心脏手术。医院感染率为16%。最常见的感染分别是血流感染（BSI）（7.75%）和呼吸道感染（7%）。1岁以下患者、急诊手术和急诊再手术后、体外循环（CPB）和主动脉阻断时间较长、机械通气时间延长、大量输血、术后心脏直视下胸骨开放、再次插管、过去三个月内在另一家医院住院的患者医院感染率较高。得出的结论是，格鲁吉亚人群先天性心脏病心脏手术后最常见的医院感染是血流感染。相同情况下医院感染的主要危险因素是1岁以下、急诊手术、急诊再手术、CPB和主动脉阻断时间长、机械通气时间长、大量输血、术后心脏直视下胸骨开放、再次插管、过去三个月内在另一家医院住院。
