Clinical and epidemiological characteristics of deep sternal incision infections in postoperative cardiac surgery patients
OBJECTIVE To investigate the pathogenic bacteria distribution of deep sternal incision infections(DSWI)in postoperative cardiac surgery patients and their epidemiology.METHODS The clinical data of 31 pa-tients with DSWI(the study group)after cardiac surgery and 55 patients without deep sternal incision infection af-ter cardiac surgery(the control group)admitted to the People's Hospital of Shaoxing City from Jan.2022 to Jan.2023 were retrospectively analyzed,the pathogenic bacteria and the drug resistance of the main pathogens of deep sternal incision infections in postoperative cardiac surgery patients were analyzed,and the epidemic characteristics of the two groups and the clinical manifestations of different types of DSWI in postoperative cardiac surgery pa-tients were analyzed.RESULTS A total of 31 strains of pathogenic bacteria were cultured and isolated from 31 pa-tients with DSWI,of which 17 strains of gram-negative bacteria accounted for 54.84％,12 strains of gram-positive bacteria accounted for 38.71％,and 2 strains of fungi accounted for 6.45％,predominantly by Pseudomonas aeruginosa,Escherichia coli,and Staphylococcus aureus.P.aeruginosa and E.coli were both＞80％resistant to ceftazidime and gentamicin,and sensitive to piperacillin and imipenem;S.aureus was resistant to penicillin and clindamycin,and sensitive to vancomycin and ticlopenem.There were significant differences in the duration of sur-gery,hospitalization,history of alcoholism,smoking,and diabetes between the two groups(P＜0.05).Among the 31 patients with DSWI,there were 8 cases of type Ⅰ,16 cases of type Ⅱ and 7 cases of type Ⅲ,with type Ⅱbeing predominant.The clinical manifestations of type Ⅰ were dominated by a white blood cell count(WBC)＞10×109/L,redness,swelling,and pain in the incision,while those of type Ⅱ were dominant by body tempera-ture＞38 ℃,WBC＞10×109/L,redness,swelling,and pain in the incision,septic or fissured incision,hy-poalbuminemia,and mediastinum widening by X-ray examination,and those of type Ⅲ were dominated by pus or fissure in the incision.CONCLUSION Postoperative deep sternal incision infections in cardiac surgery patients were dominated by P.aeruginosa,E.coli,and S.aureus,with the highest percentage of DSWI clinical typing being type Ⅱ,and there were some differences in the comparison of clinical manifestations of patients with different typeing.
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