| Objective:To investigate the independent risk factors of surgical site infection after cardiac surgery in 77 patients in Tianjin area and to analyze the drug resistance of pathogenic bacteria.Methods:A total of 8435 patients undergoing cardiac surgery in Tianjin thoracic hospital on January 1,2015(solstice,December 31,2018)were selected form 77 patients,pathogenic bacteria were cultured at the postoperative surgical site.ABO blood group was first divided into 4 groups,and 2 groups was divided by type A or not.The clinical baseline data and the distribution of pathogenic bacteria between multiple groups and two groups were compared in turn to obtain the correlation between groups.Then 200 patients without postoperative infection were randomly selected according to gender,age and ratio of surgical methods as the control group.he experimental group consisted of 77 patients with pathogenic bacteria in postoperative microbial culture at the surgical site.The clinical data of two groups of patients were analyzed for the risk factors of postoperative Surgical Site Infections(SSI),and the drug sensitivity test was conducted for the experimental group to analyze the drug resistance of pathogenic bacteria.Results:The distribution of ABO blood types in the patients with postoperative SSI was type A in 19(24.67%),non-type A in 58(75.33%)[of which 28 were type B(36.37%),20 were type O(25.98%)and 10 were type AB(12.98%)],and the difference was not statistically significant when compared with the distribution of ABO blood types in healthy people.There were no statistically significant differences in age,sex,BMI,preoperative hospital stay,diabetes,smoking history,hypertension,endotracheal intubation,surgery time,blood transfusion volume,blood loss and total hospital stay among patients with SSI in the ABO blood group.Pathogenic bacteria were detected in 51(66.2%)of the 77 patients with SSI.There were 33 strains of gram-positive bacteria,18 strains of Staphylococcus epidermidis(35.29%)and 14 strains of Staphylococcus aureus(27.45%).17 strains of Gram-negative bacteria,4 strains of Acinetobacter baumannii(7.84%),3 strains of Pseudomonas aeruginosa(5.88%)and.There was no statistically significant difference in the detection rate and specific classification of pathogens among the ABO blood group.Results in this study,the infection rate of postoperative incision infection was 0.91%(77/8435).Among the 77 cases of postoperative incision infection,31 cases(40.26%)were superficial incision infection,32 cases(41.56%)were deep incision infection,and 14 cases(18.18%)were organ(or space)infection.Compared with patients without postoperative incision infection,patients with incision infection had significant differences in smoking(p=0.007),BMI(p=0.001),blood glucose level(p=0.003),preoperative hospital stay(p=0.014),operative time(p=0.001),blood transfusion volume(p=0.028),endotracheal intubation(p=0.022)and total hospital stay(p=0.001).Smoking(OR=10.306,95%CI:3.264-32.538,P<0.05),BMI(OR= 1.333,95%CI:1.157-1.561,P<0.05),operative time(OR=1.011,95%CI:1.003-1.022,P<0.05),and total hospital stay(OR=1.215,95%CI:1.150-1.302,P<0.05)were independent risk factors for wound infection after cardiac surgery.Bacterial resistance: The drug resistance rate of S.epidermidis and S.aureus to penicillin was 100%,the drug resistance rate of clindamycin was above 60%,but there was no resistance to tegacycline,linezolid and vancomycin.The drug resistance rates of P.aeruginosa and A.baumannii to cefazolin and ampicillin were 100%.Conclusion:In Tianjin area,77 cases of independent risk factors for surgical site infection to occur after cardiac surgery is smoking history,BMI,operation time and the total length of hospital stay.Pathogenic bacteria is given priority to with Gram-positive bacteria.This is consistent with Yuhao for China and Floros abroad in Australia.The pathogenic bacteria were completely resistant to β-lactam antibiotics and were only sensitive to special grade drugs(linezolid). |
PDF Full Text Request