Bloodstream infections following different types of surgery in a Finnish tertiary care hospital, 2009-2014

Area of Science:

• Infectious Diseases
• Surgical Outcomes
• Public Health Surveillance

Background:

• Bloodstream infections (BSIs) are a significant complication following surgical procedures.
• Understanding the epidemiology and sources of BSIs is crucial for effective prevention.
• National surveillance data provides valuable insights into hospital-acquired infections.

Purpose of the Study:

• To evaluate the incidence, sources, and outcomes of bloodstream infections (BSIs) post-surgery.
• To identify specific surgical procedures with higher risks of BSIs.
• To inform targeted prevention strategies for reducing BSIs in surgical patients.

Main Methods:

• Retrospective analysis of bloodstream infection data from Helsinki University Hospital (2009-2014).
• Inclusion of data from national surveillance programs for comprehensive identification of BSIs.
• Categorization of BSIs into primary and secondary, with source identification (e.g., surgical site infections, central-line-associated BSIs).

Main Results:

• A total of 711 BSIs were identified, with 51% secondary and 49% primary.
• The highest BSI rate was observed after cardiovascular surgery (8.7 per 1000 procedures), and the lowest after gynecologic surgery (1.0 per 1000).
• Surgical site infections were the most common source of secondary BSIs (34%), and 45% of primary BSIs were central-line-associated; 28-day case fatality ranged from 0% to 21%.

Conclusions:

• Bloodstream infections pose a significant risk following surgery, with considerable variation across different surgical specialties.
• Primary BSIs, particularly those associated with central lines, and secondary BSIs originating from surgical site infections, represent key targets for infection control.
• The findings underscore the need for tailored prevention efforts, especially in high-risk surgical groups like cardiovascular surgery patients.