Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School, Hannover, Germany.
Epidemiol Infect. 2013 Jun;141(6):1207-13. doi: 10.1017/S095026881200180X. Epub 2012 Aug 21.
Surgical site infection (SSI) after vascular surgery is a serious complication increasing morbidity, mortality, and costs for healthcare systems. A 4-year retrospective cohort study was performed in a university hospital with patients who had undergone arterial vascular surgery below the aortic arch. Investigated variables included demographics and clinical data. Forty-four of 756 patients experienced SSI, 29 of which were superficial, five were deep, and 10 had organ/space infections. Coagulase-negative staphylococci (22%), enterococci (20%), and Staphylococcus aureus (18%) were the most common pathogens. Independent risk factors for SSIs were femoral grafting [odds ratio (OR) 6·7], peripheral atherosclerotic disease, Fontaine stages III-IV (OR 4·1), postoperative drainage >5 days (OR 3·6), immunosuppression (OR 2·8), duration of operation >214 min (OR 2·8), and body mass index >29 (OR 2·6). The application of perioperative antibiotic prophylaxis was an independent protective factor (OR 0·2). Patients with certain risk factors for SSIs warrant special attention for infection prevention.
血管外科手术后的手术部位感染（SSI）是一种严重的并发症，增加了医疗系统的发病率、死亡率和成本。对一家大学医院进行了一项为期 4 年的回顾性队列研究，该研究纳入了在主动脉弓以下进行动脉血管手术的患者。研究的变量包括人口统计学和临床数据。756 例患者中有 44 例发生 SSI，其中 29 例为浅表感染，5 例为深部感染，10 例为器官/腔隙感染。凝固酶阴性葡萄球菌（22%）、肠球菌（20%）和金黄色葡萄球菌（18%）是最常见的病原体。SSI 的独立危险因素包括股动脉移植[比值比（OR）6.7]、外周动脉粥样硬化疾病、Fontaine 分期 III-IV（OR 4.1）、术后引流>5 天（OR 3.6）、免疫抑制（OR 2.8）、手术时间>214 分钟（OR 2.8）和 BMI>29（OR 2.6）。围手术期预防性应用抗生素是一个独立的保护因素（OR 0.2）。对于有 SSI 特定风险因素的患者，需要特别注意感染预防。
