THE ROLE OF RISK FACTORS IN THE DEVELOPMENT OF NOSOCOMIAL INFECTION AFTER CARDIAC SURGERY



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Prevention of nosocomial infections in the postoperative period based on an assessment of the risks of their development in cardiac surgery patients is an important task from an economic point of view, which is also important for ensuring life expectancy and improving its quality in people with diseases of the cardiovascular system. The assessment of the risk of infectious complications in cardiac surgery patients is an urgent topic, which is reflected in the growing number of original articles and reviews published both in the domestic and foreign press. A literary search was conducted for the results of original research and reviews on databases Embase.com, PubMed, Research Gate, eLibrary. Based on the results of the analytical review, it was concluded that it is necessary to evaluate a set of parameters that have a synergistic effect on the risk of nosocomial infection in patients with cardiac surgery. The most significant preoperative risk factors may include age over 60 years, body mass index over 24 kg/m2, smoking, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, high-grade chronic heart failure, peripheral vascular disease, previous history of heart surgery. Immediately upon admission, the likelihood of developing IBI may be affected by severe preoperative hypoalbuminemia and anemia, low hematocrit, and a high serum creatinine level. During surgery, cardiopulmonary bypass time more than 120 minutes, intraoperative blood loss, and blood transfusion may be risk factors for the development of IBI. During surgery, as the risk factors for the development of nosocomial infections cardiopulmonary bypass time of more than 120 minutes, intraoperative blood loss of more than 2000 ml, and infusion of large volumes of blood-substituting fluids might be  considered. Artificial intelligence can be used to develop a scale for assessing risk in the future. The role of the pathobiome and the presence of foci of chronic infection in cardiac surgery patients in the development of nosocomial complications requires additional research. An endogenous source in the development of nosocomial infection may be more significant than an exogenous infection.

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作者简介

Tatiana Khomyakova

Acad.A.P. Avtsyn’s Research Institute of Human Morphology of Russian Scientific Center of Surgery named by B.V. Petrovsky, Moscow

编辑信件的主要联系方式.
Email: tatkhom@yandex.ru
ORCID iD: 0000-0003-3451-1952
SPIN 代码: 5059-1414
Scopus 作者 ID: 57218106650
Researcher ID: Q-9994-2018

PhD, senior Researcher, Laboratory of Inflammation Immunomorphology
俄罗斯联邦, 117418, Tsyurupa, 3, Moscow

Yuri Khomyakov

Non-governmental private educational institution"Synergia University"

Email: khomyakovyuri@yandex.ru
ORCID iD: 0000-0003-0540-252X
Scopus 作者 ID: 6602074139
Researcher ID: ACY-0748-2022

PhD, Senior Researcher at the Laboratory of Immunomorphology of Inflammation

俄罗斯联邦, 129090 Meshchanskaya St., 9/14, building 1, Moscow

Vladimir Mkhytarov

A.P.Avtsyn Research Institute of Human Morphology of the V.B.Petrovsky Russian National Research Surgical Сenter

Email: mkhitarov@mail.ru
ORCID iD: 0000-0002-4427-1991
SPIN 代码: 3998-2748
Scopus 作者 ID: 6507446272
Researcher ID: ABG-7356-2021

PhD, leading researcher of the Laboratory of Immunomorphology of Inflammation 

俄罗斯联邦, 117418 Tsyurupa st., 3, Moscow

Elena Ponomarenko

A.P.Avtsyn Research Institute of Human Morphology of the V.B.Petrovsky Russian National Research Surgical Сenter

Email: ponomarenkoea75@mail.ru
ORCID iD: 0000-0002-9672-7145
SPIN 代码: 7193-7254
Scopus 作者 ID: 17435598800
Researcher ID: ABG-7350-2021

Senior researcher of the Laboratory of Immunomorphology of Inflammation 

俄罗斯联邦, 117418 Tsyurupa st.,3, Moscow

Lubov Ozeretskaya

A.P.Avtsyn Research Institute of Human Morphology of the V.B.Petrovsky Russian National Research Surgical Сenter

Email: lozloz.o@yandex.ru

Laboratory assistant researcher at the Laboratory of Immunomorphology of Inflammation

俄罗斯联邦, 117418 Tsyurupa st.3, Moscow

参考

  1. Massart N, Mansour A, Ross JT, Piau C, Verhoye JP, Tattevin P, Nesseler N. Mortality due to hospital-acquired infection after cardiac surgery. J Thorac Cardiovasc Surg. 2022 Jun;163(6):2131-2140.e3. doi: 10.1016/j.jtcvs.2020.08.094. Epub 2020 Sep 2. PMID: 32981703.
  2. Liu JY, Dickter JK. Nosocomial Infections: A History of Hospital-Acquired Infections. Gastrointest Endosc Clin N Am. 2020 Oct;30(4):637-652. doi: 10.1016/j.giec.2020.06.001. Epub 2020 Jul 30. PMID: 32891222.
  3. Rijnhart-de Jong HG, Haenen J, Porta F, Timmermans M, Boerma EC, de Jong K. Hospital infections and health-related quality of life after cardiac surgery: a multicenter survey. J Cardiothorac Surg. 2024 Feb 10;19(1):84. doi: 10.1186/s13019-024-02559-4. PMID: 38336817; PMCID: PMC10858541.
  4. Pérez-Granda MJ, Barrio JM, Cuerpo G, Valerio M, Muñoz P, Hortal J, Pinto AG, Bouza E; Cardiovascular Infection Study Group. Infectious complications following major heart surgery from the day of the surgery to hospital discharge. BMC InfectDis. 2024 Jan 11;24(1):73. doi: 10.1186/s12879-023-08972-9. PMID: 38200426; PMCID: PMC10782676.
  5. Hyoju S, Machutta K, Krezalek MA, Alverdy JC. What Is the Role of the Gut in Wound Infections? Adv Surg. 2023 Sep;57(1):31-46. doi: 10.1016/j.yasu.2023.05.002. Epub 2023 Jun 25. PMID: 37536860; PMCID: PMC10837732
  6. The Order of the Ministry of Health of the Russian Federation No. 1108n dated November 29, 2021 “On approval of the procedure for preventive measures, detection and registration in a medical organization of cases of infectious diseases related to the provision of medical care, the nomenclature of infectious diseases related to the provision of medical care to be detected and registered in a medical organization” [In Russian ]
  7. Damavandi DS, Javan M, Moshashaei H, Forootan M, Darvishi M. Microbial Contamination after Cardiac Surgery in a Hospital Cardiac Surgery Ward. J Med Life. 2020 Jul-Sep;13(3):342-348. doi: 10.25122/jml-2019-0071. PMID: 33072206; PMCID: PMC7550159.
  8. Stepin A.V. Preoperative and intraoperative risk factors for infection in the field of surgical intervention in a cardiac surgery hospital: a retrospective study. Pathology of blood circulation and cardiac surgery. 2023;27(1):30-37. https://dx.doi. org/10.21688/1681-3472-2023-1-30-3 [In Russian]
  9. Abukhodair A, Alqarni MS, Alzahrani A, Bukhari ZM, Kadi A, Baabbad FM, Algarni A, Jamalallail S, Almohammadi M, Bennett SR. Risk Factors for Postoperative Infections in Cardiac Surgery Patients: A Retrospective Study. Cureus. 2023 Aug 17;15(8):e43614. doi: 10.7759/cureus.43614. PMID: 37719533; PMCID: PMC10504570.
  10. Cutrell JB, Barros N, McBroom M, Luby J, Minhajuddin A, Ring WS, Greilich PE. Risk factors for deep sternal wound infection after cardiac surgery: Influence of red blood cell transfusions and chronic infection. Am J Infect Control. 2016 Nov 1;44(11):1302-1309. doi: 10.1016/j.ajic.2016.03.027. Epub 2016 May 11. PMID: 27179393.
  11. Williamson KC, Fabbri D. Classifying infection risk following pediatric cardiac surgery. AMIA Annu Symp Proc. 2023 Apr 29;2022:1153-1162. PMID: 37128399; PMCID: PMC10148375
  12. Bokeria L. A., Golukhova E. Z., Merzlyakov V. Yu., Shumkov K. V., Madresova A. T. Risk factors and a system for predicting the development of postoperative complications in cardiac surgery patients. Creative cardiology. 2011; 2: 24–36. [In Russian]
  13. Chernyavsky A.M., Turkova A.R., Ruzmetov T.M., Morozov S.V., Grigoriev I.A. Infections in cardiac surgery. Surgery 5, 2016, with 64-=68 doi: 10.17116/hirurgia2016564-68 [In Russian]
  14. Phoon PHY, Hwang NC. Deep sternal wound infection: diagnosis, treatment and prevention. J Cardiothorac Vasc Anesth. 2020 Jun;34(6):1602-1613. doi: 10.1053/j.jvca.2019.09.019. Epub 2019 Sep 18. PMID: 31623967
  15. Wang D, Huang X, Wang H, Le S, Yang H, Wang F, Du X. Risk factors for postoperative pneumonia after cardiac surgery: a prediction model. J Thorac Dis. 2021 Apr;13(4):2351-2362. doi: 10.21037/jtd-20-3586. PMID: 34012584; PMCID: PMC8107540.
  16. Song Y, Gu J, Yang J. Risk factors for ventilator-associated pneumonia after cardiac surgery with cardiopulmonary bypass. Asian J Surg. 2024 Feb;47(2):1279-1280. doi: 10.1016/j.asjsur.2023.11.064. Epub 2023 Nov 25. PMID: 38008615.
  17. Papazian L, Klompas M, Luyt CE. Ventilator-associated pneumonia in adults: a narrative review. Intensive Care Med. 2020 May;46(5):888-906. doi: 10.1007/s00134-020-05980-0. Epub 2020 Mar 10. PMID: 32157357; PMCID: PMC7095206.
  18. Lv X, Han Y, Liu D, Chen X, Chen L, Huang H, Huang C. Risk factors for nosocomial infection in patients undergoing extracorporeal membrane oxygenation support treatment: A systematic review and meta-analysis. PLoS One. 2024 Nov 25;19(11):e0308078. doi: 10.1371/journal.pone.0308078. PMID: 39585868; PMCID: PMC11588223.
  19. Charlwood KV, Jackson J, Vaja R, Rogers LJ, Dawson S, Moawad KR, Brown J, Trevis J, Vokshi I, Layton GR, Magboo R, Tanner J, Rochon M, Murphy GJ, Whiting P. Identifying potential predictors of the risk of surgical site infection following cardiac surgery: a scoping review. J Hosp Infect. 2025 Mar;157:29-39. doi: 10.1016/j.jhin.2024.12.002. Epub 2024 Dec 15. PMID: 39681168.
  20. Gillen JR, Isbell JM, Michaels AD, Lau CL, Sawyer RG. Risk factors for urinary tract infections in cardiac surgical patients. Surg Infect (Larchmt). 2015 Oct;16(5):504-8. doi: 10.1089/sur.2013.115. Epub 2015 Jun 26. PMID: 26115336; PMCID: PMC4593882.
  21. Sadovnikov E.E. Risk factors of infection of patients through neurosurgical profile factor cardiac urinary tract. Modern aspects of health saving : Proceedings of Conference devoted to the 60th anniversary of State University "BSMU", Minsk, 24-25 October. 2024 Minsk, 2024. pp. 413-418. [In Russian ]
  22. Zardi, E. M. Nosocomial Extracardiac infections after cardiac surgery. Current infectious disease reports. 2022. 24(11). 159–171. https://doi.org/10.1007/s11908-022-00787-0.
  23. Seo SH, Jeong IS, Lee EJ. Impact of obesity on urinary tract infections in korean adults: secondary data analysis using community-based cohort study. J Korean Acad Nurs. 2021 Apr;51(2):150-161. doi: 10.4040/jkan.20228. PMID: 33993122.
  24. Guidelines "Epidemiology and prevention of catheter-associated bloodstream infections and central venous catheter care" ICD 10: T80.2, vol.82.7, R65.0, R65.1 Year of approval (frequency of revision): 2023 (revision every 3 years) [in Russian ]
  25. Timsit JF, Ruppé E, Barbier F, Tabah A, Bassetti M. Bloodstream infections in critically ill patients: an expert statement. Intensive Care Med. 2020 Feb;46(2):266-284. doi: 10.1007/s00134-020-05950-6. Epub 2020 Feb 11. PMID: 32047941; PMCID: PMC7223992.
  26. DeMerle KM, Angus DC, Baillie JK, Brant E, Calfee CS, Carcillo J, Chang CH, Dickson R, Evans I, Gordon AC, Kennedy J, Knight JC, Lindsell CJ, Liu V, Marshall JC, Randolph AG, Scicluna BP, Shankar-Hari M, Shapiro NI, Sweeney TE, Talisa VB, Tang B, Thompson BT, Tsalik EL, van der Poll T, van Vught LA, Wong HR, Yende S, Zhao H, Seymour CW. Sepsis Subclasses: A Framework for Development and Interpretation. Crit Care Med. 2021 May 1;49(5):748-759. doi: 10.1097/CCM.0000000000004842. PMID: 33591001; PMCID: PMC8627188.
  27. de la Varga-Martínez O, Gómez-Sánchez E, Muñoz MF, Lorenzo M, Gómez-Pesquera E, Poves-Álvarez R, Tamayo E, Heredia-Rodríguez M. Impact of nosocomial infections on patient mortality following cardiac surgery. J Clin Anesth. 2021 May;69:110104. doi: 10.1016/j.jclinane.2020.110104. Epub 2020 Nov 19. PMID: 33221707.
  28. Liu Z, Zhang X, Zhai Q. Clinical investigation of nosocomial infections in adult patients after cardiac surgery. Medicine (Baltimore). 2021 Jan 29;100(4):e24162. doi: 10.1097/MD.0000000000024162. PMID: 33530207; PMCID:PMC7850681.
  29. Zardi EM, Chello M, Zardi DM, Barbato R, Giacinto O, Mastroianni C, Lusini M. Nosocomial Extracardiac Infections After Cardiac Surgery. Curr Infect Dis Rep. 2022;24(11):159-171. doi: 10.1007/s11908-022-00787-0. Epub 2022 Sep 24. PMID: 36187899; PMCID: PMC9510267.
  30. Alsulami OA, Konkar AE, Alalyani AA, Alghamdi MS, Eid SM, Alsulami HA, Al-Ebrahim KE. Postoperative Pneumonia Following Open Heart Surgery. Cureus. 2020 Sep 8;12(9):e10320. doi: 10.7759/cureus.10320. PMID: 33052281; PMCID: PMC7546606.
  31. Karruli A, de Cristofaro J, Andini R, Iossa D, Bernardo M, Amarelli C, Mattucci I, Zampino R, Zarrilli R, Durante-Mangoni E. Risk Factors and Outcome of Multidrug-Resistant Infections after Heart Transplant: A Contemporary Single Center Experience. Microorganisms. 2021 Jun 3;9(6):1210. doi: 10.3390/microorganisms9061210. PMID: 34205082; PMCID: PMC8230299
  32. Wang M, Xu X, Wu S, Sun H, Chang Y, Li M, Zhang X, Lv X, Yang Z, Ti X. Risk factors for ventilator-associated pneumonia due to multi-drug resistant organisms after cardiac surgery in adults. BMC CardiovascDisord. 2022 Nov 4;22(1):465. doi: 10.1186/s12872-022-02890-5. PMID: 36333679; PMCID: PMC9636807.
  33. Hyoju S, Machutta K, Krezalek MA, Alverdy JC. What Is the Role of the Gut in Wound Infections? Adv Surg. 2023 Sep;57(1):31-46. doi: 10.1016/j.yasu.2023.05.002. Epub 2023 Jun 25. PMID: 37536860; PMCID: PMC10837732.
  34. Cappe M; Pierre-Françoisb L.; Mélanie D. Preoperative frailty screening, assessment and management. Current Opinion in Anaesthesiology 36(1):p 83-88, February 2023. | doi: 10.1097/ACO.0000000000001221
  35. Hassoun-Kheir N, Hussein K, Abboud Z, Raderman Y, Abu-Hanna L, Darawshe A, Bolotin G, Paul M. "Risk factors for ventilator-associated pneumonia following cardiac surgery: case-control study". J Hosp Infect. 2020 Apr 10:S0195-6701(20)30184-5. doi: 10.1016/j.jhin.2020.04.009
  36. Stepin A.V. Infectious complications in the field of surgical intervention in cardiac surgery: etiology and the role of antimicrobial prophylaxis. Surgery. The N.I. Pirogov Magazine. 2022;6:40–47. https://doi.org/10.17116/hirurgia202206140 [In Russian]
  37. Rzucidło-Hymczak A, Hymczak H, Olechowska-Jarząb A, Gorczyca A, KapelakB,Drwiła R, Plicner D. Clostridioides difficile infection after cardiac surgery: Assessment of prevalence, risk factors and clinical outcomes-retrospective study. PeerJ. 2020 Sep 29;8:e9972. doi: 10.7717/peerj.9972. PMID: 33062429; PMCID: PMC7531357.
  38. Conoscenti E, Blot S. A necessary evil: Central venous catheters. Intensive Crit Care Nurs. 2020 Apr;57:102810. doi: 10.1016/j.iccn.2020.102810. Epub 2020 Feb 3. PMID: 32029380.
  39. Menekşe Ş, Altınay E, Oğuş H, Kaya Ç, Işık ME, Kırali K. Risk Factors for Mortality in Patients with Stenotrophomonas maltophilia Bloodstream Infections in Immunocompetent Patients. Infect Dis Clin Microbiol. 2022 Sep 26;4(3):178-184. doi: 10.36519/idcm.2022.173. PMID: 38633400; PMCID: PMC10986715
  40. Giacobbe DR, Salsano A, Del Puente F, Miette A, Vena A, Corcione S, Bartoletti M, Mularoni A, Maraolo AE, Peghin M, Carnelutti A, Losito AR, Raffaelli F, Gentile I, Maccari B, Frisone S, Pascale R, Mikus E, Medaglia AA, Conoscenti E, Ricci D, Lupia T, Comaschi M, Giannella M, Tumbarello M, De Rosa FG, Del Bono V, Mikulska M, Santini F, Bassetti M. Risk Factors for Candidemia After Open Heart Surgery: Results From a Multicenter Case-Control Study. Open Forum Infect Dis. 2020 Jun 19;7(8):ofaa233. doi: 10.1093/ofid/ofaa233. PMID: 32766378; PMCID: PMC739782
  41. Madrasova A. T., Lukashkin M. A., Golukhova E. Z., Lobacheva G. V., Merzlyakov V. Yu., Shumilov K. V. and others. Postoperative pulmonary complications in cardiac surgery patients. Creative cardiology. 2010; 1: 5–16. [In Russian]
  42. Shevchenko Yu.L., Suslov R.P. Postoperative infectious and inflammatory complications in cardiothoracic surgery Bulletin of the National Medical and Surgical Center named after N.I. Pirogov 2022, vol. 17, No. 1: 84-89. https://doi.org / 10.25881/20728255_2022_17_1_84 [In Russian]
  43. O'Boyle, Colm & Macfie, John & Mitchell, Chloe & Johnstone, D & Sagar, P.M. & Sedman, P.C. Microbiology of bacterial translocation in humans. Gut. 42. 29-35. 10.1136/gut.42.1.29. Cappe M; Pierre-Françoisb L.; Mélanie D. Preoperative frailty screening, assessment and management. Current Opinion in Anaesthesiology 1998.-36(1):p 83-88, February 2023. | doi: 10.1097/ACO.0000000000001221
  44. Hyoju S, Machutta K, Krezalek MA, Alverdy JC. What Is the Role of the Gut in Wound Infections? Adv Surg. 2023 Sep;57(1):31-46. doi: 10.1016/j.yasu.2023.05.002. Epub 2023 Jun 25. PMID: 37536860; PMCID: PMC10837732
  45. Cappe M; Pierre-Françoisb L.; Mélanie D. Preoperative frailty screening, assessment and management. Current Opinion in Anaesthesiology 36(1):p 83-88, February 2023. | doi: 10.1097/ACO.0000000000001221
  46. Branch-Elliman W, O’Brien W, Strymish J, Itani K, Wyatt C, Gupta K. Association of Duration and Type of Surgical Prophylaxis With Antimicrobial-Associated Adverse Events. JAMA Surg. 2019;154(7):590- 598. https://doi.org/10.1001/jamasurg.2019.0569
  47. Cho BH, Aziz KT, Giladi AM. The Impact of Smoking on Early Postoperative Complications in Hand Surgery. J Hand Surg Am. 2021 Apr;46(4):336.e1-336.e11. doi: 10.1016/j.jhsa.2020.07.014. Epub 2020 Aug 28. PMID: 32868099.
  48. Palermo J, Tingey S, Khanna AK, Segal S. Evaluation and Prevention of Perioperative Respiratory Failure. JClinMed. 2024 Aug 27;13(17):5083. doi: 10.3390/jcm13175083. PMID: 39274295; PMCID: PMC11396761
  49. Eckmann C, Aghdassi SJS, Brinkmann A, Pletz M, Rademacher J. Perioperative Antibiotic Prophylaxis—Indications and Modalities for the Prevention of Postoperative Wound Infection. DtschArztebl Int. 2024 Apr 5;121(7):233-242. doi: 10.3238/arztebl.m2024.0037. PMID: 38440828; PMCID: PMC11539872.
  50. Zhang N, Fan K, Ji H, Ma X, Wu J, Huang Y, Wang X, Gui R, Chen B, Zhang H, Zhang Z, Zhang X, Gong Z, Wang Y. Identification of risk factors for infection after mitral valve surgery through machine learning approaches. Front CardiovascMed. 2023 Jun 13;10:1050698. doi: 10.3389/fcvm.2023.1050698. PMID: 37383697; PMCID: PMC10294678.

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