Analisi differenziale sulla diagnostica e il trattamento delle infezioni nosocomiali in ambito postoperatorio cardiochirurgico. Studio retrospettivo effettuato presso Cardiochirurgia ospedale San Martino di Genova

The mortality rate of infections following cardiac surgery has always been very high due to the special conditions of the cardiac surgical patient and the risk of infection with bacteria characterised by an extended spectrum of resistance. The aim of our study was to evaluate which patients were at increased risk of infection with multi-resistant bacteria in a cardiac surgery setting and which patients could benefit from treatment with drugs with a less extensive spectrum of action, in order to save certain types of antibiotic and to generate a lower risk of infection with multi-resistant bacteria. A retrospective case-control analysis was therefore performed on cardiac surgical patients in the time period 2017-2019 analysing the variables classically correlated with increased risk of infection by multi-resistant bacteria. A total of 206 infections were considered by comparing cases (patients infected with multi-resistant bacteria) and controls (patient infected with susceptible bacteria). The results show that the risk of infection with multi-resistant bacteria is most strongly correlated with the presence of a higher Charlson score and a longer duration of previous antibiotic treatment in relation to hospital days. The conclusion of the study, which is limited by its observational nature and the presence of only one study centre, is that a shorter duration of antibiotic treatment in appropriately selected patients could have a positive impact on infections following cardiac surgery.