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接受心脏手术患者的细胞回收机回收的红细胞中的菌血症。

Bacteremia in the red blood cells obtained from the cell saver in patients submitted to heart surgery.

作者信息

Luque-Oliveros Manuel

机构信息

Universidad de Sevilla, Sevilla, Espanha.

出版信息

Rev Lat Am Enfermagem. 2020;28:e3337. doi: 10.1590/1518-8345.3092.3337. Epub 2020 Aug 31.

Abstract

OBJECTIVE

to determine the microbiological characteristics of the red blood cells obtained with the cell saver in heart surgery patients on an extra-body circuit.

METHOD

a cross-sectional and descriptive study conducted with 358 patients scheduled for heart surgery where the saver was used. Sociodemographic variables were collected, as well as from the saver and of the microbial identification in the re-infusion bag proceeding from the cell saver. Informed consent performed.

RESULTS

of the 170 GRAM+ bacteria isolations, the most frequent species were Staphylococcus epidermidis in 69% (n=138) of the cases and Streptococcus sanguinis with a report of 10% (n=20). Significant differences were found in the Staphylococcus epidermidis strain in patients with a Body Mass Index ≥25 (p=0.002) submitted to valve surgery (p=0.001). Vancomycin was the antimicrobial which resisted the Staphylococcus epidermidis strain with a minimum inhibitory concentration of >16 µg/ml.

CONCLUSION

the microbiological characteristics of the red blood cells obtained after processing autologic blood recovered with the cell saver during heart surgery are of GRAM+ bacterial origin, the most isolated species being Staphylococcus epidermidis. Consequently, in order to reduce the presence of these GRAM+ cocci, an antibiotic should be added to the cell saver reservoir, according to a previously established protocol.

摘要

目的

确定在体外循环心脏手术患者中使用血液回收机获取的红细胞的微生物学特征。

方法

对358例计划进行心脏手术且使用血液回收机的患者进行横断面描述性研究。收集社会人口统计学变量,以及血液回收机和来自血液回收机的再输注袋中的微生物鉴定结果。已获得知情同意。

结果

在170株革兰氏阳性菌分离株中,最常见的菌种是表皮葡萄球菌,占69%(n = 138),血链球菌报告占10%(n = 20)。在体重指数≥25的患者(p = 0.002)和接受瓣膜手术的患者(p = 0.001)中,表皮葡萄球菌菌株存在显著差异。万古霉素是对表皮葡萄球菌菌株耐药的抗菌药物,最低抑菌浓度>16μg/ml。

结论

心脏手术期间使用血液回收机回收自体血液后获得的红细胞的微生物学特征为革兰氏阳性菌来源,最常见的分离菌种是表皮葡萄球菌。因此,为了减少这些革兰氏阳性球菌的存在,应根据先前制定的方案在血液回收机储液器中添加抗生素。

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