Verkkala K
Department of Thoracic and Cardiovascular Surgery, University Central Hospital, Helsinki, Finland.
Ann Clin Res. 1987;19(3):170-7.
A prospective study of postoperative infectious complications after open-heart surgery was carried out in 885 patients. A total 200 postoperative infections occurred in 173 patients, an overall incidence was 19.5%. The mortality rate was 0.8%. The incidence of sternal wound infections was 7.7% (superficial 6.3% and deep 1.4%) and of leg wound infections 11.4%. Superficial sternal wound infections were associated with septicaemia in 10.7% and deep sternal wound infections in 33.3%. The leg wound infections caused no blood culture positive septicaemia. The incidence of urinary tract infections was 4.6% while respiratory tract infections occurred in only 2.5%. Early prosthetic valve endocarditis occurred in only one patient (0.3%). Staphylococcus aureus and epidermidis were the two bacteria most frequently cultured from sternal wound infections (82.4%), while gram-negative bacteria alone were seldom found (5.9%). In leg wound infections the incidence of gram-negative bacteria was greater (17.3%). Although E. coli was the causative agent in 37% of postoperative urinary tract infections the incidence of infection by the classical hospital-acquired organisms (klebsiella and pseudomonas) was also high (32%). Postoperative infections caused an average prolongation of hospital stay of 8 days. The increase was shortest for urinary tract infections (5 days) and longest in patients with postoperative mediastinitis (28 days).
对885例接受心脏直视手术的患者进行了术后感染并发症的前瞻性研究。173例患者共发生200例术后感染，总发生率为19.5%。死亡率为0.8%。胸骨伤口感染发生率为7.7%（浅表感染6.3%，深部感染1.4%），腿部伤口感染发生率为11.4%。浅表胸骨伤口感染合并败血症的发生率为10.7%，深部胸骨伤口感染合并败血症的发生率为33.3%。腿部伤口感染未导致血培养阳性败血症。尿路感染发生率为4.6%，而呼吸道感染仅发生2.5%。早期人工瓣膜心内膜炎仅发生1例（0.3%）。金黄色葡萄球菌和表皮葡萄球菌是胸骨伤口感染中最常培养出的两种细菌（82.4%），而单独的革兰氏阴性菌很少见（5.9%）。在腿部伤口感染中，革兰氏阴性菌的发生率更高（17.3%）。虽然大肠杆菌是37%的术后尿路感染的病原体，但经典医院获得性微生物（克雷伯菌和假单胞菌）的感染发生率也很高（32%）。术后感染使平均住院时间延长8天。尿路感染延长的时间最短（5天），术后纵隔炎患者延长的时间最长（28天）。
