Zardi Enrico Maria, Chello Massimo, Zardi Domenico Maria, Barbato Raffaele, Giacinto Omar, Mastroianni Ciro, Lusini Mario
Internistic Ultrasound Service, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo 200, 00128 Rome, Italy.
Unit of Cardiovascular Surgery, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Álvaro del Portillo 200, 00128 Rome, Italy.
Curr Infect Dis Rep. 2022;24(11):159-171. doi: 10.1007/s11908-022-00787-0. Epub 2022 Sep 24.
Nosocomial extracardiac infections after cardiac surgery are a major public health issue affecting 3-8.2% of patients within 30-60 days following the intervention.
Here, we have considered the most important postoperative infective complications that, in order of frequency, are pneumonia, surgical site infection, urinary tract infection, and bloodstream infection. The overall picture that emerges shows that they cause a greater perioperative morbidity and mortality with a longer hospitalization time and excess costs. Preventive interventions and corrective measures, diminishing the burden of nosocomial extracardiac infections, may reduce the global costs. A multidisciplinary team may assure a more appropriate management of nosocomial extracardiac infections leading to a reduction of hospitalization time and mortality rate.
The main and most current data on epidemiology, prevention, microbiology, diagnosis, and management for each one of the most important postoperative infective complications are reported. The establishment of an antimicrobial stewardship in each hospital seems to be, at the moment, the more valid strategy to counteract the challenging problems.
心脏手术后的医院获得性心外感染是一个重大的公共卫生问题,影响3%至8.2%的患者,发生在干预后的30至60天内。
在此,我们考虑了最重要的术后感染并发症,按发生频率依次为肺炎、手术部位感染、尿路感染和血流感染。整体情况表明,它们会导致更高的围手术期发病率和死亡率,住院时间延长且费用增加。预防性干预和纠正措施可减轻医院获得性心外感染的负担,可能降低总体成本。多学科团队可确保对医院获得性心外感染进行更恰当的管理,从而缩短住院时间并降低死亡率。
报告了关于每种最重要的术后感染并发症的流行病学、预防、微生物学、诊断和管理的主要及最新数据。目前,在每家医院建立抗菌药物管理似乎是应对这些挑战性问题的最有效策略。