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首页> 外文期刊>Journal of Clinical Medicine Research >Hospital-Acquired Infections After Cardiac Surgery and Current Physician Practices: A Retrospective Cohort Study
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Hospital-Acquired Infections After Cardiac Surgery and Current Physician Practices: A Retrospective Cohort Study

机译：心脏手术和当前医师实践后医院收养的感染：回顾性队列研究

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Background: The management of hospital-acquired infections (HAIs) with respect to physician practices remains largely unexplored despite increasing efforts to standardize care. In the present study, we report findings from a 2-month audit of all patients that have undergone cardiac surgery at a large referral center in Atlantic Canada.Methods: All patients who underwent cardiac surgical procedures during May and June 2013 at the Queen Elizabeth II Health Sciences Center in Halifax, Nova Scotia were identified. The prevalence of urinary tract infections (UTIs), pneumonia, leg harvest site infections, superficial sternal wound infections, deep sternal wound infections, and sepsis was examined to determine physician approaches in terms of verification rates (microbiology), time of diagnosis and duration of treatment. Continuous variables were compared using Student’s?t-test and categorical variables were analyzed using Fischer’s exact test.Results: A total of 185 consecutive patients underwent cardiac surgical procedures, of which 39 (21%) developed at least one postoperative infection. The overall prevalence of infection types, from highest to lowest, was UTI (8%), pneumonia (7%), leg harvest site infection (5%), superficial surgical site infection (4%), and sepsis (2%). There were no deep sternal wound infections. The overall in-hospital mortality rate was 3.8% with a median length of stay (LOS) of 8 days. The overall infection verification rate was 50% (ranged from 100% in sepsis to 10% in leg harvest site infections). In all cases, a full course of antibiotics was administered despite negative microbiology cultures or limited evidence of an actual infection.Conclusions: HAIs are commonly treated without being verified and treatment is often not discontinued after negative cultures are received. Our findings highlight the fact that antibiotic treatment is not always supported by evidence, and the effect of this could contribute to increased selective pressure for antimicrobial resistant bacteria.J Clin Med Res. 2017;9(1):10-16doi: https://doi.org/10.14740/jocmr2637w
机译：背景：尽管越来越努力标准化关怀，但医院收购的感染（HAI）的管理仍然很大程度上是未开发的。在本研究中，我们从大西洋加拿大大型推荐中心在大型推荐中心在大型推荐中心进行了2个月的患者的调查结果。方法：所有在2003年5月和6月在伊丽莎白女王举行的心脏外科手术的患者鉴定了哈利法克斯的健康科学中心。尿路感染（UTIS），肺炎，腿部收获遗址感染，浅表伤口感染，深度伤口感染和败血症的患病率被检查，以确定在验证率（微生物学），诊断时间和持续时间方面的医生方法治疗。使用学生的确切测试分析了连续变量的T-Test和分类变量进行了比较。结果：总共185名患者接受了心脏外科手术的患者，其中39（21％）术后至少术后感染。感染类型的总体流行率，从最高到最低，是UTI（8％），肺炎（7％），腿收获遗址感染（5％），表面外科遗址感染（4％）和败血症（2％）。没有深刻的伤口感染。整体中医院死亡率为3.8％，中位数长度（LOS）为8天。整体感染验证率为50％（术中脓毒症的100％到腿收获遗址感染10％）。在所有情况下，尽管存在负面的微生物学文化或实际感染的有限证据，但仍有全部抗生素疗程。结论：在收到阴性培养后通常不会停止治疗，常见治疗。我们的研究结果强调了抗生素治疗并不总是通过证据支持的事实，这对抗微生物抗性细菌的选择性增加有助于增加抗菌药物。 2017; 9（1）：10-16DOI：https：//doi.org/10.14740/jocmr2637w

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