[The spectrum of bacterial strains and problems of antibiotic prophylaxis in an intensive care unit]

Out of a total number of 1,935 patients of a mainly cardiac surgically orientated intensive care unit, 103 material extractions and 111 germ diagnoses with resistance examinations were carried out in 60 patients. The infection rate was 3.1%. Thirty-two of the 60 patients died (53.3%). Fifty-seven patients (95%) underwent open-heart surgery. With respect to the total number of open-heart operations (n = 1,345), the rate of severe infections was 4.23%. The germ spectrum reveals a predominance of "problem germs", especially pseudomonas and enterobacteria. The results of the resistance examinations show that no antibiotic combination is suitable for complete germ elimination. Cefotiam (halospor) is effective against 50% of the germs. Problems of an antibiotic prophylaxis are shown. Recommendations are given to restrict antibiotic prophylaxis to 24 hours perioperatively, preferably using a cephalosporin preparation.