Epidemiological monitoring of the healthcare-associated infection risk in patients of a cardiac surgery hospital at different stages of hospitalization

封面

如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

Background. The frequency of infectious complications in cardiac surgery varies widely, and the mortality rate reaches 30%. Active implementation of risk-oriented technologies requires ensuring a high level of epidemiological safety.

Objective. Evaluation of the effectiveness of epidemiological monitoring technology for assessing the risk of infection.

Materials and methods. For 153 days, all 111 patients admitted for planned coronary artery bypass grafting underwent continuous prospective epidemiological observation with microbiological monitoring of colonization of the main loci. Biological material was collected from three loci at five stages of the patient’s stay in the hospital. The quality of disinfection was controlled by washings from environmental objects (764 samples). 242 samples of various materials and instruments were tested for sterility.

Results. The most common microorganisms were Klebsiella pneumoniae, Staphylococcus aureus, Enterobacter cloacae. During microbiological monitoring, colonization of patients with Klebsiella pneumoniae at the stage of surgery was revealed during transesophageal echocardiography, which increased the likelihood of infection by 9.58 times. An analysis of discrepancies and their correction were performed, which excluded the transmission of the pathogen during the procedure.

Conclusion. Epidemiological monitoring technology is an effective diagnostic measure for assessing the risk of healthcare-associated infections. Epidemiological monitoring with microbiological control provides assessing the risk of infection and suggesting measures to minimize it.

全文:

受限制的访问

作者简介

Evgeny Sadovnikov

Kemerovo State Medical University, Ministry of Health of the Russia

编辑信件的主要联系方式.
Email: evsadov1@gmail.com
ORCID iD: 0000-0002-4335-0962

Postgraduate Student, Department of Epidemiology, Infectious Diseases and Dermatovenereology

俄罗斯联邦, Kemerovo

Vera Sakharova

Research Institute of Complex Issues of Cardiovascular Diseases

Email: sahavm@kemcardio.ru
ORCID iD: 0000-0002-7458-0621

Bacteriologist

俄罗斯联邦, Kemerovo

Olga Barbarash

Research Institute of Complex Issues of Cardiovascular Diseases

Email: barbol@kemcardio.ru
ORCID iD: 0000-0002-4642-3610

Professor, Academician of the Russian Academy of Sciences, МD, Director

俄罗斯联邦, Kemerovo

Elena Brusina

Kemerovo State Medical University, Ministry of Health of the Russia

Email: brusina@mail.ru
ORCID iD: 0000-0002-8616-3227

Professor, Corresponding Member of the Russian Academy of Sciences, МD, Head, Department of Epidemiology, Infectious Diseases and Dermatovenereology

俄罗斯联邦, Kemerovo

参考

  1. Голухова Е.З., Семенов В.Ю., Милиевская Е.Б., Прянишников В.В. Обеспеченность высокотехнологичной медицинской помощью по профилю «сердечно-сосудистая хирургия» жителей субъектов российской федерации в 2021 году. Комплексные проблемы сердечно-сосудистых заболеваний 2023; 12(2): 77–87. doi: 10.17802/2306-1278-2023-12-2-77-87
  2. Golukhova E.Z., Semenov V.Yu., Milievskaya E.B., Pryanishnikov V.V. [Provision of high-tech cardiovascular care to residents of the russian federation regions in 2021]. Complex Issues of Cardiovascular Diseases 2023; 12(2): 77–87. (In Russ.). doi: 10.17802/2306-1278-2023-12-2-77-87
  3. Ferreira G.B., Donadello J.C.S., Mulinari L.A. Healthcare-Associated Infections in a Cardiac Surgery Service in Brazil. Braz. J. Cardiovasc. Surg. 2020; 35(5): 614–618. doi: 10.21470/1678-9741-2019-0284
  4. Степин А.В. Влияние некоторых интраоперационных факторов на возникновение инфекционных осложнений в кардиохирургии. Уральский медицинский журнал 2021; 20(1): 36–43. doi: 10.52420/2071-5943-2021-20-1-36-43/Stepin A.V. [Impact of some intraoperative factors on wound infection in cardiac surgery]. Ural Medical Journal 2021; 20(1): 36–43. (In Russ.). doi: 10.52420/2071-5943-2021-20-1-36-43
  5. Barnetet N.M., Liesman D.R., Strobel R.J., Wu X., Plane G., DeLucia A. 3rd et al. The association of intraoperative and early postoperative events with risk of pneumonia following cardiac surgery. J. Thorac. Cardiovasc. Surg. 2024; 168(4): 1144–1154.e3. DOI: 10.1016/ j.jtcvs.2023.09.056
  6. Тураев Ф.Ф., Мирходжаев И.И. Современная концепция профилактики и хирургического лечения стерномедиастинита после кардиохирургических операций: Журнал кардиореспираторных исследований 2020: 1(1): 40–50. doi: 10.26739/2181/Turaev F.F., Mirkhodzhaev I.I. [The modern concept of prophylaxis and surgical treatment of sternomediastinitis after cardiac surgery]. Journal of Сardiorespiratory Research 2020; 1(1): 40–50. (In Russ.). doi: 10.26739/2181
  7. Blot S., Ruppé E., Harbarth S., Asehnoune K., Poulakou G., Luyt C.E. et al. Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies. Intensive Crit. Care Nurs 2022; 70: 103227. doi: 10.1016/j.iccn.2022.103227
  8. Брусина Е.Б., Ковалишина О.В., Цигельник А.М. Инфекции, связанные с оказанием медицинской помощи в хирургии: тенденции и перспективы профилактики. Эпидемиология и Вакцинопрофилактика 2017; 16(4): 73–80. doi: 10.31631/2073-3046-2017-16-4-73-80/Brusina E.B., Kovalishena O.V., Tsigelnik A.M. [Healthcare-Associated Infections: Trends and Prevention Prospectives]. Epidemiology and Vaccinal Prevention 2017; 16(4): 73–80. (In Russ.). doi: 10.31631/2073-3046-2017-16-4-73-80
  9. Желнина Т.П., Брусина Е.Б. Эффективность эпидемиологического мониторинга в профилактике инфекций, связанных с оказанием медицинской помощи. Эпидемиология и Вакцинопрофилактика. 2019; 18(3): 84–88. doi: 10.31631/2073-3046-2019-18-3-84-88/Gelnina T.P., Brusina E.B. [Efficiency of Epidemiological Monitoring in Prevention of Helhcare-Associated Infections]. Epidemiology and Vaccinal Prevention. 2019; 18(3): 84–88. (In Russ.). doi: 10.31631/2073-3046-2019-18-3-84-88
  10. Кондаурова С.Л., Панасюк Ю.В., Лис А.П., Алейникова О.В. Отделение инфекционного контроля в онкогематологическом стационаре. Медицинские новости 2020; 10(313): 59–63./Kondaurova S. L., Panasyuk Yu. V., Lis A. P., Aleinikova O. V. [Infection control department in an oncohematology hospital]. Medical News 2020; 10(313): 59–63. (In Russ.).
  11. Li H., Zheng X., Gao J. Extensive analysis of risk factors associated with surgical site infections post-cardiothoracic open surgery. Int. Wound J. 2024; 21(3): e14842. doi: 10.1111/iwj.14842
  12. Квашнина Д.В., Ковалишена О.В., Сутырина О.М., Соловьева И.В., Белова И.В., Точилина А.Г., Широкова И.Ю. Эпидемическое неблагополучие по катетер-ассоциированным инфекциям кровотока среди пациентов, получающих заместительную почечную терапию. Эпидемиология и Вакцинопрофилактика. 2019; 18(2): 52–61. doi: 10.31631/2073-3046-2019-18-2-52-61/Kvashnina D.V., Kovalishena O.V., Sutyrina O.M., Solov’yeva I.V., Belova I.V., Tochilina A.G., Shirokova I.Yu. [Epidemic Outbreak of Catheter-Associated Bloodstream Infections among Patients Receiving Renal Replacement Therapy]. Epidemiology and Vaccinal Prevention 2019; 18(2): 52–61. (In Russ.). doi: 10.31631/2073-3046-2019-18-2-52-61
  13. Садовников Е.Е., Поцелуев Н.Ю., Барбараш О.Л., Брусина Е.Б. Эпидемиологические особенности инфекций, связанных с оказанием медицинской помощи, в кардиохирургии. Фундаментальная и клиническая медицина 2023; 8(4): 73–84. doi: 10.23946/2500-0764-2023-8-4-73-84/Sadovnikov E.E., Potseluev N.Yu., Barbarash O.L., Brusina E.B. [Healthcare-associated infections in cardiac surgery: epidemiological features]. Fundamental and Clinical Medicine 2023; 8(4): 73–84. (In Russ.) doi: 10.23946/2500-0764-2023-8-4-73-84
  14. Liu Z., Zhang X., Zhai Q. Clinical investigation of nosocomial infections in adult patients after cardiac surgery. Medicine 2021; 100(4): e24162. doi: 10.1097/MD.0000000000024162
  15. Pérez-Granda M.J., Barrio J.M., Cuerpo G., Valerio M., Muñoz P., Hortal J. et al. Infectious complications following major heart surgery from the day of the surgery to hospital discharge. BMC Infect. Dis. 2024; 24(1): 73. doi: 10.1186/s12879-023-08972-9
  16. Янчевский П.Н., Ершова М.В., Чернова H.Н., Янович Р.В. Локальный микробиологический мониторинг в отделениях анестезиологии и реанимации Гродненской университетской клиники. Журнал Гродненского государственного медицинского университета 2022; 20(1): 73–79. doi: 10.25298/2221-8785-2022-20-1-73-79/Yancheuskу P.N., Yarshova M.V., Chernova N.N., Yanovich R.V. [Local microbiological monitoring in the departments of anesthesiology and intensive care of the Grodno University Clinic]. Journal of the Grodno State Medical University 2022; 20(1): 73–79. (In Russ.) doi: 10.25298/2221-8785-2022-20-1-73-79
  17. Захватова А.С., Дарьина М.Г., Светличная Ю.С., Зуева Л.П., Асланов Б.И., Червякова М.А. Микробиологический мониторинг антимикробной резистентности потенциальных возбудителей инфекций кровотока. Инфекция и иммунитет 2022; 12(1): 185–192. doi: 10.15789/2220- 7619-ARM-1552./Zakhvatova A.S., Daryina M.G., Svetlichnaya Y.S., Zueva L.P., Aslanov B.I., Chervyakova M.A. [Antimicrobial resistance monitoring of potential pathogens causing bloodstream infections]. Russian Journal of Infection and Immunity. 2022; 12(1): 185–192. (In Russ.). doi: 10.15789/2220-7619-ARM-1552
  18. Боброва О.П., Фетисов А.О., Зырянов С.К. Микробиологический мониторинг многопрофильной медицинской организации: основа стратегического планирования в рамках реализации эпидемиологической безопасности. Качественная клиническая практика 2023; (4): 86–95. doi: 10.37489/2588-0519-2023-4-86-95/Bobrova O.P., Fetisov A.O., Zyryanov S.K. [Microbiological monitoring of a multidisciplinary medical organization: the basis of strategic planning in the framework of the implementation of epidemiological safety]. Good Clinical Practice 2023; (4): 86–95. (In Russ.). doi: 10.37489/2588-0519-2023-4-86-95
  19. Bagate F., Rouzé A., Zerimech F., Boissier F., Labbe V., Razazi K. et al. Transesophageal echocardiography-associated tracheal microaspiration and ventilator-associated pneumonia in intubated critically ill patients: a multicenter prospective observational study. Crit. Care 2020; 24(1): 679–689. doi: 10.1186/s13054-020-03380-w
  20. Van Maerken T., De Brabandere E., Noël A., Coorevits L., de Waegemaeker P. et al. A recurrent and transesophageal echocardiography-associated outbreak of extended-spectrum β-lactamase-producing Enterobacter cloacae complex in cardiac surgery patients. Antimicrob. Resist. Infect. Control 2019; (8): 152–166. doi: 10.1186/s13756-019-0605-4
  21. Vesteinsdottir E., Helgason K.O., Sverrisson K.O., Gudlaugsson O., Karason S. Infections and outcomes after cardiac surgery-The impact of outbreaks traced to transesophageal echocardiography probes. Acta Anaesthesiol. Scand. 2019; 63(7): 871–878. doi: 10.1111/aas.13360
  22. Alghamdi B.A., Alharthi R.A., Alshaikh B.A., Alosaimi M.A., Alghamdi A.Y., Yusnoraini N. et al. Risk Factors for Post-cardiac Surgery Infections. Cureus 2022; 14(11): e31198. doi: 10.7759/cureus.31198.
  23. Фатхуллина Л.С., Гололобова Т.В., Александрова О.Ю., Матвеева Е.А., Шестопалова Т.Н., Рулева А.И. Разработка и применение системы стандартных операционных процедур в медицинской организации как инструмента обеспечения безопасности медицинской деятельности. Проблемы стандартизации в здравоохранении 2020; (1–2): 43–51. (In Russ.). doi: 10.26347/1607-2502202001-02043-051/Fatkhullina L.S., Gololobova T.V., Aleksandrova O.Yu., Matveeva E.A., Shestopalova T.N., Ruleva A.I. [Development and application of a standard operating procedure system in a medical organization as a tool for ensuring the safety of medical activities]. Health care Standardization Problems 2020; (1–2): 43–51. (In Russ.). doi: 10.26347/1607-2502202001-02043-051

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Dynamics of colonization by microorganisms pharyngeal colonization of patients

下载 (23KB)
索引源数据
3. Fig. 2. Dynamics of colonization by microorganisms of the nasal cavity of patients

下载 (21KB)
索引源数据

版权所有 © Bionika Media, 2025