Incisional surgical infection in heart transplantation

Abstract

ISSIs in HT are frequently caused by resistant bacteria and Candida, but are associated with good prognosis.

Clinical practice guidelines for antimicrobial prophylaxis in surgery

“…As with other types of cardiothoracic procedures, grampositive organisms, mainly Staphylococcus species, are the primary pathogens that cause SSI after heart transplantation. 902,[905][906][907]912,913 MRSA was reported in 12-21% of SSIs in several cohort studies. 903,905,906 Vancomycin-resistant Enterococcus faecalis was noted in 15% of infections in one cohort study.…”

“…903,905,906 Vancomycin-resistant Enterococcus faecalis was noted in 15% of infections in one cohort study. 903 Other gram-positive pathogens (e.g., coagulase-negative staphylococci, Enterococcus species) 903,[905][906][907]913 and gram-negative organisms (e.g., Enterobacteriaceae, P. aeruginosa, Stenotrophomonas maltophilia) are also a concern for SSIs in heart transplant recipients, as are Candida species. 903,906 Efficacy.…”

“…903 Other gram-positive pathogens (e.g., coagulase-negative staphylococci, Enterococcus species) 903,[905][906][907]913 and gram-negative organisms (e.g., Enterobacteriaceae, P. aeruginosa, Stenotrophomonas maltophilia) are also a concern for SSIs in heart transplant recipients, as are Candida species. 903,906 Efficacy. Despite the paucity of literature on antimicrobial prophylaxis for the prevention of SSIs in heart transplantation, the efficacy noted in other cardiac surgical procedures has made it the standard of practice during transplantation.…”

“…Heart transplantation has been identified as an independent risk factor for SSIs. 170 Other independent risk factors for SSIs in heart transplantation include age, 905 receipt of ciprofloxacin alone for prophylaxis, 906 positive wire cultures, 907 a BMI of >30 kg/m 2 , female sex, 908 previous cardiac procedures, previous left VAD placement, and hemodynamic instability requiring inotropic support. 903,904 Unfavorable functional outcomes were seen in patients who developed infections within the first year after heart transplantation associated with lung, bloodstream, and CMV infections.…”

Diabetes mellitus is associated with increased risk of surgical site infections: A meta-analysis of prospective cohort studies

“…Of these, 1,185 studies were excluded after the first screening based on abstracts or titles, leaving 81 articles for full-text review. After assessing the full-text of the 81 potentially relevant articles, 67 articles were excluded for the reasons listed in Figure 1, leaving 14 studies [22][23][24][25][26][27][28][29][30][31][32][33][34][35] included for the final analyses.…”