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A prospective study of hospital-acquired infection in 2330 cardiovascular surgery patients
Abstract:
Between March 1982 and May 1983, 2330 patients undergoing cardiovascular surgery were prospectively surveyed for hospital-acquired infections. During the first month of the study the overall incidence of infection was 8.2%, the incidence of postoperative wound infection was 3.8%, urinary tract infection 3.2%, lower respiratory tract infection 1.2% and bacteraemia 0.6%. In May 1983 the overall incidence was 3.2% and incidence of wound, urinary tract and lower respiratory infections were 1.3%, 0.6% and 1.3% respectively. Urinary tract infection was reduced by substituting a closed drainage system for open drainage. A peak of postoperative wound infection was observed in November 1982 and was related to changes in the functioning of the department resulting in inadequate pre-operative preparation. Two outbreaks of pseudobacteraemia occurred related to the arterial line stopcock and to heparin used for biochemistry tests. Antimicrobial prophylaxis was not modified during the study. However, wound infection rates dropped from 4% to 1.3%. In conclusion, this surveillance programme was associated with a significant reduction in hospital-acquired infection.
Insights
A hospital surveillance program significantly reduced hospital-acquired infections in cardiovascular surgery patients. This involved implementing a closed drainage system and improving pre-operative preparation, leading to lower infection rates.
Area of Science:
- Infectious Diseases
- Hospital Epidemiology
- Surgical Site Infections
Background:
- Hospital-acquired infections (HAIs) pose a significant risk to patients undergoing cardiovascular surgery.
- Monitoring infection rates is crucial for identifying trends and implementing effective control measures.
Purpose of the Study:
- To prospectively survey hospital-acquired infections in cardiovascular surgery patients.
- To evaluate the impact of a surveillance program on HAI incidence.
Main Methods:
- Prospective surveillance of 2330 patients undergoing cardiovascular surgery from March 1982 to May 1983.
- Monitoring of overall infection rates and specific types: postoperative wound, urinary tract, lower respiratory tract, and bacteraemia.
- Investigating specific outbreaks and correlating infection rates with departmental changes and procedures.
Main Results:
- Overall HAI incidence decreased from 8.2% to 3.2%.
- Specific infection rates reduced: wound infection from 3.8% to 1.3%, urinary tract infection from 3.2% to 0.6%, and lower respiratory tract infection from 1.2% to 1.3%.
- Identified causes for infection peaks, including inadequate pre-operative preparation and contaminated medical devices/reagents.
Conclusions:
- A dedicated surveillance program was associated with a significant reduction in hospital-acquired infections.
- Specific interventions, such as closed drainage systems, contributed to decreased infection rates.
- Continuous monitoring and investigation of outbreaks are vital for maintaining infection control in surgical settings.