Impact of Antibiotic Prophylaxis on Surgical Site Infections in Cardiac Surgery.

antibiotic prophylaxis cardiac surgery cardiopulmonary bypass cephalosporins gentamicin surgical site infection vancomycin

Journal

Antibiotics (Basel, Switzerland)
ISSN: 2079-6382
Titre abrégé: Antibiotics (Basel)
Pays: Switzerland
ID NLM: 101637404

Informations de publication

Date de publication:
04 Jan 2023
Historique:
received: 26 11 2022
revised: 27 12 2022
accepted: 29 12 2022
entrez: 21 1 2023
pubmed: 22 1 2023
medline: 22 1 2023
Statut: epublish

Résumé

(1) Background: Cephalosporins (CA) are the first-line antibiotic prophylaxis recommended to prevent surgical site infection (SSI) after cardiac surgery. The combination of vancomycin/gentamicin (VGA) might represent a good alternative, but few studies have evaluated its efficacy in SSI prevention. (2) Methods: A single-centre retrospective study was conducted over a 13-year period in all consecutive adult patients undergoing elective cardiac surgery. Patients were stratified according to the type of antibiotic prophylaxis. CA served as the first-line prophylaxis, and VGA was used as the second-line prophylaxis. The primary endpoint was SSI occurrence at 90 days, which was defined as the need for reoperation due to SSI. (3) Results: In total, 14,960 adult patients treated consecutively from 2006 to 2019 were included in this study, of whom 1774 (12%) received VGA and 540 (3.7%) developed SSI. VGA patients had higher severity with increased 90-day mortality. Nevertheless, the frequency of SSI was similar between CA and VGA patients. However, the microbiological aetiologies were different, with more Gram-negative bacteria noted in the VGA group. (4) Conclusions: VGA seems to be as effective as CA in preventing SSI.

Identifiants

pubmed: 36671286
pii: antibiotics12010085
doi: 10.3390/antibiotics12010085
pmc: PMC9854463
pii:
doi:

Types de publication

Journal Article

Langues

eng

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Auteurs

Christian de Tymowski (C)

Department of Anaesthesiology and Surgical Intensive Care, DMU PARABOL, AP-HP, Hôpital Bichat, 75018 Paris, France.
Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM UMR 1149, CNRS ERL8252, F-75018 Paris, France.
Laboratory of Excellence, Inflamex, Université Paris Cité, F-75018 Paris, France.
Department of Immunology, DHU Fire, AP-HP, Hôpital Bichat, 75018 Paris, France.

Tarek Sahnoun (T)

Department of Anaesthesiology and Surgical Intensive Care, DMU PARABOL, AP-HP, Hôpital Bichat, 75018 Paris, France.

Sophie Provenchere (S)

Department of Anaesthesiology and Surgical Intensive Care, DMU PARABOL, AP-HP, Hôpital Bichat, 75018 Paris, France.
INSERM Clinical Investigation Center 1425, 75018 Paris, France.

Marylou Para (M)

Department of Cardiac Surgery, AP-HP, Hôpital Bichat, 75018 Paris, France.
UFR Paris Nord, Université Paris Cité, 75006 Paris, France.

Nicolas Derre (N)

Department of Anaesthesiology and Surgical Intensive Care, DMU PARABOL, AP-HP, Hôpital Bichat, 75018 Paris, France.

Pierre Mutuon (P)

Service MSI, AP-HP, Hôpital Bichat, 75018 Paris, France.

Xavier Duval (X)

INSERM Clinical Investigation Center 1425, 75018 Paris, France.
UFR Paris Nord, Université Paris Cité, 75006 Paris, France.
Université Paris Cité, INSERM, IAME, F-75018 Paris, France.

Nathalie Grall (N)

Université Paris Cité, INSERM, IAME, F-75018 Paris, France.
Service de Bactériologie, AP-HP, Hôpital Bichat, 75018 Paris, France.

Bernard Iung (B)

UFR Paris Nord, Université Paris Cité, 75006 Paris, France.
Cardiology Department, AP-HP, Bichat Hospital, Université Paris Cite, INSERM 1148, 46 Rue Henri Huchard, 75018 Paris, France.

Solen Kernéis (S)

UFR Paris Nord, Université Paris Cité, 75006 Paris, France.
Université Paris Cité, INSERM, IAME, F-75018 Paris, France.
Equipe de Prévention du Risque Infectieux (EPRI), AP-HP, Hôpital Bichat, 75018 Paris, France.

Jean-Christophe Lucet (JC)

UFR Paris Nord, Université Paris Cité, 75006 Paris, France.
Université Paris Cité, INSERM, IAME, F-75018 Paris, France.
Equipe de Prévention du Risque Infectieux (EPRI), AP-HP, Hôpital Bichat, 75018 Paris, France.

Philippe Montravers (P)

Department of Anaesthesiology and Surgical Intensive Care, DMU PARABOL, AP-HP, Hôpital Bichat, 75018 Paris, France.
UFR Paris Nord, Université Paris Cité, 75006 Paris, France.
Université Paris Cité, Physiopathologie et Epidémiologie des Maladies Respiratoires, INSERM UMR 1152, F-75018 Paris, France.

Classifications MeSH