未经批准:尽管在手术技术和管理方面取得了进步,手术部位感染(SSI)在心血管手术后仍然很重要。我们进行了调查,以确定术前鼻咽培养物(NCx)是否可以预测SSI及其微生物谱。
UNASSIGNED:在2013年至2018年期间,对1226例接受NCx和正中胸骨切开术的心脏和胸主动脉手术的连续患者进行了回顾性审查,这些患者接受了标准SSI束的护理。对从NCx和SSI病原体中分离的微生物进行计数,以探索有和没有术后SSI的患者的微生物模式和相关变量。围手术期管理未因术前NCx的收集而改变。
未经证实:有1281和127种微生物,包括最普遍的凝固酶阴性葡萄球菌,从784个鼻标本和111个咽标本中分离,分别。术后31例(2.47%)发生SSI,包括胸部,腹股沟,和腿SSI。未观察到SSI病原体与NCx微生物的显着重合。然而,有SSI的患者术前NCx阳性率明显高于无SSI的患者.NCx对SSI的敏感性/特异性为鼻部81%/37%,咽部45%/92%,分别。NCx对排除SSI的阴性预测值为鼻98.6%,咽部98.4%,分别。术后SSI的独立危险因素包括女性、糖尿病,术前NCx阳性,和术后使用PortexMini-Trach(SmithsMedical,明尼阿波利斯,Minn)或气管造口术进行多变量分析。
UNASSIGNED:术前NCx可用于预测胸骨正中切开心脏直视手术后的SSI,以及耐甲氧西林金黄色葡萄球菌的筛查。
UNASSIGNED: Despite advances in surgical techniques and management, surgical site infection (SSI) is still important after cardiovascular surgery. We investigated to determine whether or not preoperative nasopharyngeal cultures (NCx) can predict SSI and its microbial spectrum.
UNASSIGNED: A retrospective review was done in 1226 consecutive patients undergoing NCx and cardiac and thoracic aortic surgery via median sternotomy who were cared for with the standard SSI bundle between 2013 and 2018. Microorganisms isolated from the NCx and SSI pathogens were counted to explore the microbial pattern and associated variables in patients with and without postoperative SSI. Perioperative management was not changed by collection of preoperative NCx.
UNASSIGNED: There were 1281 and 127 microorganisms, including coagulase-negative Staphylococcus as the most prevalent, isolated from 784 nasal and 111 pharyngeal specimens, respectively. Postoperative SSI occurred in 31 patients (2.47%), including chest, groin, and leg SSI. Significant coincidence of the SSI pathogens with the NCx microorganisms was not observed. However, the patients with SSI showed significantly higher positive rates of preoperative NCx than those without SSI. The sensitivity/specificity of NCx for SSI were 81%/37% for nasal and 45%/92% for pharyngeal, respectively. The negative predictive value of NCx for ruling out SSI was 98.6% for nasal and 98.4% for pharyngeal, respectively. Independent risk factors for postoperative SSI included female sex, diabetes mellitus, positive preoperative NCx, and postoperative use of Portex Mini-Trach (Smiths Medical, Minneapolis, Minn) or tracheostomy on multivariate analysis.
UNASSIGNED: Preoperative NCx may be useful to predict SSI after open heart surgery via median sternotomy, as well as screening for methicillin-resistant Staphylococcus aureus.