Mediastinitis post revascularización miocárdica: impacto del cambio de profilaxis antibiótica en la fundación Cardioinfantil 2012 - 2013

dc.contributorCastañeda Luquerna, Aurora Ximena
dc.creatorPerez-Fernandez, Oscar-Mauricio
dc.date.accessioned2015-02-16T12:08:37Z
dc.date.available2015-02-16T12:08:37Z
dc.date.created2015-02-16T12:08:37Z
dc.date.issued2015
dc.identifierhttp://repository.urosario.edu.co/handle/10336/10181
dc.identifierhttps://doi.org/10.48713/10336_10181
dc.description.abstractINTRODUCTION. Post coronary artery bypass graft (CABG) mediastinitis is an uncommon but potentially lethal infection. In recent years a rising trend of this infection has been observed at the Fundación Cardioinfantil (FCI), that it is why, a change on antimicrobial prophylaxis protocol, from cephalosporins (standard therapy) to vancomycin-gentamicin (second-line therapy) was made. However, the impact of these measures is not yet known. OBJETIVE: To determine whether the change of antibiotic prophylaxis in patients undergoing to CABG influences a decrease on mediastinitis incidence from 2012 to 2013. METHODS: A retrospective cohort study was conducted by evaluating the rates of mediastinitis after isolated CABG in patients underwent 2 different types of antimicrobial prophylaxis (cephalosporins vs. vancomycin-gentamicin). Patterns of susceptibility and resistance of pathogens most frequently found in mediastinitis, and mortality of this disease were also described. RESULTS: The pathogens most frequently isolated in mediastinitis were Staphylococcus aureus and Klebsiella pneumoniae, in a monomicrobial pattern in most of patients. Some pathogens with resistance profiles of clinical importance as extended-spectrum beta-lactamases in Gram-negative, and methicillin resistance in Gram positive cocci were found. The relative risk (RR) of mediastinitis of the cohort exposed to vancomycin-gentamicin compared to cephalosporin cohort was 0, 9 with 95% CI: 0, 28 to 3, 28. CONCLUSION: Microbial epidemiology of mediastinitis at FCI did not significantly differ from the literature reports. The antimicrobial prophylaxis therapy with vancomycin-gentamicin in patients undergoing to isolated CABG did not reduce the mediastinitis incidence. Return to prophylactic therapy with cephalosporins has been proposed to FCI.
dc.languagespa
dc.publisherUniversidad del Rosario
dc.publisherEspecialización en Medicina Interna
dc.publisherFacultad de Medicina
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rightsAbierto (Texto completo)
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dc.source1.Magalhães MGP de A, Alves LMO, Alcantara LF de M, Bezerra SMM da S. [Post-operative mediastinitis in a heart hospital of Recife: contributions for nursing care]. Rev Esc Enferm USP.2012 Aug;46(4):865–71.
dc.source2. Speir AM, Kasirajan V, Barnett SD, Fonner E. Additive costs of postoperative complications for isolated coronary artery bypass grafting patients in Virginia. Ann Thorac Surg. 2009 Jul;88(1):40–5; discussion 45–6.
dc.source3. Van Schooneveld TC, Rupp ME. Mediastinitis. Mandell: Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases, 7th ed. 7th ed. 2009. p. 1173–82.
dc.source4. Bryan CS, Yarbrough WM. Preventing Deep Wound Infection after Coronary Artery Bypass Grafting. Texas Hear Inst J. 2013;40(2):125–39.
dc.source5. Dalen JE, Alpert JS, Goldberg RJ, Weinstein RS. The Epidemic of the 20(th) Century: Coronary Heart Disease. Am J Med. 2014
dc.source6. Molina JAD, Bee HH. Global trends in cardiology and cardiothoracic surgery - An opportunity or a threat? Annals of the Academy of Medicine Singapore. 2009. p. 541–5.
dc.source7. The Society for Cardiothoracic Surgery in Great Britain &Ireland. Sixth National Adult Cardiac Surgical Database Report 2008. 2008 p. 0–514.
dc.source8. Edwards FH, Engelman1. Edwards FH, Engelman RM, Houck P, Shahian DM, Bridges CR. The Society of Thoracic Surgeons Practice Guideline Series : Antibiotic Prophylaxis in Cardiac Surgery , Part I : Duration *. Ann Thorac Surg. 2006;81:397–404. RM, Houck P, Shahian DM, Bridges CR. The Society of Thoracic Surgeons Practice Guideline Series : Antibiotic Prophylaxis in Cardiac Surgery , Part I : Duration *. Ann Thorac Surg. 2006;81:397–404.
dc.source9. Engelman R, Shahian D, Shemin R, Guy TS, Bratzler D, Edwards F, et al. The Society of Thoracic Surgeons practice guideline series: Antibiotic prophylaxis in cardiac surgery, part II: Antibiotic choice. Ann Thorac Surg. 2007 Apr;83(4):1569–76.
dc.source10. Michael CA, Dominey-Howes D, Labbate M. The antimicrobial resistance crisis: causes, consequences, and management. Front public Heal. 2014
dc.source11. Ennker IC, Ennker JC. Management of sterno-mediastinitis. HSR Proc Intensive Care Cardiovasc Anesth. 2012;4:233–41.
dc.source12. Yap C-H, Mohajeri M, Yii M. Obesity and early complications after cardiac surgery. Med J Aust. 2007;186:350–4.
dc.source13. Fowler VG, O’Brien SM, Muhlbaier LH, Corey GR, Ferguson TB, Peterson ED. Clinical predictors of major infections after cardiac surgery. Circulation. 2005 Aug 30;112(9 Suppl):I358–65.
dc.source14. Tiveron MG, Fiorelli AI, Mota EM, Vilca OA, Manuel C, Brandão DA, et al. Preoperative risk factors for mediastinitis after cardiac surgery : assessment of 2768 patients. Rev Bras Cir Cardiovasc. 2012;27(2):203–10.
dc.source15. Gabriella M, Andrada P De, Medeiros L, Alves O, Fábia L, Alcantara DM, et al. Heart Hospital of Recife : contributions for nursing care. 2012;46(4):863–9.
dc.source16. Rosanova MT, Allaria A, Santillan A, Hernandez C, Landry L, Ceminara R, et al. Risk factors for infection after cardiovascular surgery in children in Argentina. Braz J Infect Dis. 2009 Dec;13(6):414–6.
dc.source17. Silva LE, Buitrago AF, Maldonado J, Gómez M, Rendon I, Restrepo J, et al. Tasa de infección en el sitio operatorio en cirugía de revascularización miocárdica en la Fundación Santa Fe de Bogotá. Rev Colomb Cardiol. 2010;18(3):158–61.
dc.source18. Parada J, Chalela T, Bresciani R, Camacho J, Carreño M, Sánchez O, et al. Factores asociados a la aparición de mediastinitis en Cirugia de revascularización miocárdica. Universidad del Rosario; 2012. p. 11–39.
dc.source19. Perez-Fernandez O, Mejía J, Paramo L, Arango A, Castañeda X. Mediastinitis posterior a cirugía cardíaca: análisis descriptivo de 21 casos en un hospital especializado en enfermedades cardiovasculares. Bogotá, Colombia. Valencia; 2014.
dc.source20. Horan TC, Andrus M, Dudeck M a. CDC/NHSN surveillance definition of health careassociated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control. 2008 Jun;36(5):309–32.
dc.source21. Fariñas MC, Gald Peralta F, Bernal JM, Rabasa JM, Revuelta JM, González-Macías J. Suppurative mediastinitis after open-heart surgery: a case-control study covering a seven-year period in Santander, Spain. Clin Infect Dis. 1995 Feb;20(2):272–9.
dc.source22. Trouillet J-L, Vuagnat A, Combes A, Bors V, Chastre J, Gandjbakhch I, et al. Acute poststernotomy mediastinitis managed with debridement and closed-drainage aspiration: factors associated with death in the intensive care unit. J Thorac Cardiovasc Surg. 2005 Mar;129(3):518–24.
dc.source23. Ho J, Reslerova M, Gali B, Nickerson PW, Rush DN, Sood MM, et al. Serum creatinine measurement immediately after cardiac surgery and prediction of acute kidney injury. Am J Kidney Dis. 2012 Feb;59(2):196–201.
dc.source24. Sampaio MC, Máximo CAG, Montenegro CM, Mota DM, Fernandes TR, Bianco ACM, et al. Comparison of diagnostic criteria for acute kidney injury in cardiac surgery. Arq Bras Cardiol. 2013 Jul;101(1):18–25.
dc.source25. Bastin AJ, Ostermann M, Slack AJ, Diller G-P, Finney SJ, Evans TW. Acute kidney injury after cardiac surgery according to Risk/Injury/Failure/Loss/End-stage, Acute Kidney Injury Network, and Kidney Disease: Improving Global Outcomes classifications. J Crit Care. 2013 Aug;28(4):389–96.
dc.source26. Gualis J, Flórez S, Tamayo E, Álvarez FJ, Castrodeza J, Castaño M, et al. Risk Factors for Mediastinitis and Endocarditis after Cardiac Surgery. Asian Cardiovasc Thorac Ann. 2009;17(6):612–6.
dc.source27. Karra R, McDermott L, Connelly S, Smith P, Sexton DJ, Kaye KS. Risk factors for 1-year mortality after postoperative mediastinitis. J Thorac Cardiovasc Surg. 2006 Sep;132(3):537–43.
dc.source28. Leung S, Sang W, Chaturvedi R, Alam A, Samoukovic G, Varennes B De. Preoperative hospital length of stay as a modifiable risk factor for mediastinitis after cardiac surgery. J Cardiothorac Surg. Journal of Cardiothoracic Surgery; 2013;8(1):45.
dc.source29. Chifiriuc MC, Banu O, Bleotu C, Lazar V. Interaction of bacteria isolated from clinical biofilms with cardiovascular prosthetic devices and eukaryotic cells. Anaerobe. 2011 Dec;17(6):419–21.
dc.source30. CDC/NHSN Surveillance Definitions for Specific Types of Infections. 2013.
dc.source31. Silva LE, Maldonado J, Silva S. Tasa de infección en el sitio operatorio en cirugía de revascularización miocárdica en la Fundación Santa Fe de Bogotá. 2010;18(3):158–61
dc.source32. Franco S, Herrera AM, Atehortúa M, Vélez L, Botero J, Jaramillo JS, et al. Use of steel bands in sternotomy closure: implications in high-risk cardiac surgical population. Interact Cardiovasc Thorac Surg. 2009 Feb;8(2):200–5.
dc.source33. Parada JM, Carreño M, Camacho J, Sandoval NF, Umaña juan P. Factores asociados a la aparición de mediastinitis en 2.073 revascularizaciones miocárdicas. Rev Colomb Cardiol. 2014;21(2):119–24.
dc.source34. Finkelstein R, Rabino G, Mashiah T, Bar-El Y, Adler Z, Kertzman V, et al. Vancomycin versus cefazolin prophylaxis for cardiac surgery in the setting of a high prevalence of methicillinresistant staphylococcal infections. J Thorac Cardiovasc Surg. 2002 Feb;123(2):326–32
dc.source35. Maki DG, Bohn MJ, Stolz SM, Kroncke GM, Acher CW, Myerowitz PD. Comparative study of cefazolin, cefamandole, and vancomycin for surgical prophylaxis in cardiac and vascular operations. A double-blind randomized trial. J Thorac Cardiovasc Surg. 1992 Nov;104(5):1423–34.
dc.source36. Movahed M-R, Kasravi B, Bryan CS. Prophylactic use of vancomycin in adult cardiology and cardiac surgery. J Cardiovasc Pharmacol Ther. 2004;9:13–20.
dc.source37. Grace E. Altered vancomycin pharmacokinetics in obese and morbidly obese patients: What we have learned over the past 30 years. J Antimicrob Chemother. 2012;67:1305–10.
dc.source38. Crawford T, Rodvold KA, Solomkin JS. Vancomycin for surgical prophylaxis? Clinical Infectious Diseases. 2012. p. 1474–9.
dc.source39. Kaiser AB, Petracek MR, Lea JW, Kernodle DS, Roach AC, Alford WC, et al. Efficacy of cefazolin, cefamandole, and gentamicin as prophylactic agents in cardiac surgery. Results of a prospective, randomized, double-blind trial in 1030 patients. Ann Surg. 1987 Dec;206(6):791–7.
dc.source40. Zanetti G, Giardina R, Platt R. Intraoperative redosing of cefazolin and risk for surgical site infection in cardiac surgery. Emerg Infect Dis. 2001;7:828–31.
dc.source41. Tamayo E, Gualis J, Flórez S, Castrodeza J, Eiros Bouza JM, Álvarez FJ. Comparative study of single-dose and 24-hour multiple-dose antibiotic prophylaxis for cardiac surgery. J Thorac Cardiovasc Surg. 2008;136:1522–7.
dc.source42. Paul M, Porat E, Raz A, Madar H, Fein S, Bishara J, et al. Duration of antibiotic prophylaxis for cardiac surgery: prospective observational study. J Infect. 2009;58:291–8.
dc.source43. Hall JC, Christiansen K, Carter MJ, Edwards MG, Hodge AJ, Newman MA, et al. Antibiotic prophylaxis in cardiac operations. Ann Thorac Surg. 1993 Oct;56(4):916–22.
dc.sourceinstname:Universidad del Rosario
dc.sourcereponame:Repositorio Institucional EdocUR
dc.subjectMediastinitis
dc.subjectRevascularización miocárdica
dc.subjectProfilaxis antimicrobiana
dc.titleMediastinitis post revascularización miocárdica: impacto del cambio de profilaxis antibiótica en la fundación Cardioinfantil 2012 - 2013
dc.typemasterThesis


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