@article{01HRSVFDN6PZ1D2MEX1PY6FCQY,
  abstract     = {{Objectives
To identify risk factors for surgical site infections following cardiosurgery in an area endemic for multidrug resistant organisms.

Design
Single-center, historical cohort study including patients who underwent cardiosurgery during a 6-year period (2014–2020).

Setting
Joint Commission International accredited, multiorgan transplant center in Palermo, Italy.

Main outcome measures
Surgical site infection was the main outcome.

Results
On a total of 3609 cardiosurgery patients, 184 developed surgical site infection (5.1 %). Intestinal colonization with multidrug resistant organisms was more frequent in patients with surgical site infections (69.6 % vs. 33.3 %; p < 0.001). About half of surgical site infections were caused by Gram-negative bacteria (n = 97; 52.7 %). Fifty surgical site infections were caused by multidrug resistant organisms (27.1 %), with extended-spectrum Beta-lactamase-producing Enterobacterales (n = 16; 8.7 %) and carbapenem-resistant Enterobacterales (n = 26; 14.1 %) being the predominant resistance problem. However, in only 24 of surgical site infections caused by multidrug resistant organisms (48 %), mostly carbapenem-resistant Enterobacterales (n = 22), a pathogen match between the rectal surveillance culture and surgical site infections clinical culture was demonstrated. Nevertheless, multivariate logistic regression analysis identified a rectal swab culture positive for multidrug resistant organisms as an independent risk factor for SSI (odds ratio 3.95, 95 % confidence interval 2.79–5.60). Other independent risk factors were female sex, chronic dialysis, diabetes mellitus, previous cardiosurgery, previous myocardial infarction, being overweight/obese, and longer intubation time.

Conclusion
In an area endemic for carbapenem-resistant Enterobacterales, intestinal colonization with multidrug resistant organisms was recognized as independent risk factor for surgical site infections.}},
  articleno    = {{103612}},
  author       = {{Conoscenti, Elena and Enea, Giuseppe and Deschepper, Mieke and Huis in 't Veld, Diana and Campanella, Maria and Raffa, Giuseppe and Arena, Giuseppe and Morsolini, Marco and Alduino, Rossella and Tuzzolino, Fabio and Panarello, Giovanna and Mularoni, Alessandra and Martucci, Gennaro and Mattina, Alessandro and Blot, Stijn}},
  issn         = {{0964-3397}},
  journal      = {{INTENSIVE AND CRITICAL CARE NURSING}},
  keywords     = {{Critical Care Nursing,Surgical wound infection,Intensive care units,Infection control,Epidemiology,Cardiac surgical procedures,Microbial,Drug resistance}},
  language     = {{eng}},
  pages        = {{7}},
  title        = {{Risk factors for surgical site infection following cardiac surgery in a region endemic for multidrug resistant organisms}},
  url          = {{http://doi.org/10.1016/j.iccn.2023.103612}},
  volume       = {{81}},
  year         = {{2024}},
}

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