Dear Members of ID-IRI Community

Following the completion of ID-IRI “SSIs Post-cardiac Surgery Study”, the data underwent analysis, and the manuscript was subsequently submitted elsewhere. Below is the confirmed list of authors and the summary of the results, for your reference.

List of Authors

Hakan Erdem^1,2, Handan Ankarali³, Jaffar A.  Al-Tawfiq^4,5, Kumar Angamuthu⁶, Dragan Piljic⁷, Ajdin Umihanic⁷,  Farouq Dayyab², Dilek Karamanlioğlu⁸, Abdullah Umut Pekok⁹, Meliha Cagla-Sonmezer¹⁰, Amani El-Kholy¹¹, Maha A. Gad¹¹, Lazar Velicki¹², Ozay Akyildiz¹³, Mustafa Altindis¹⁴, Dilşah Başkol-Elik¹⁵, Buket Erturk-Sengel¹⁶, İbrahim Kara¹⁷, Umit Kahraman¹⁸, Mehmet Özdemir¹⁹, Hulya Caskurlu²⁰, Yasemin Cag²⁰, Abdulwahab Al-Khalifa⁷, Atousa Hakamifard^21,22, Marina Kljaković-Gašpić Batinjan²³, Muhammad Tahir²⁴, Elif Tukenmez-Tigen¹⁶, Joanna Zajkowska²⁵, Jehan ElKholy²⁶, Hrvoje Gašparović²⁷, Ozlem Gul²⁸, Hamed Azhdari Tehrani²⁹, Elif Doyuk-Kartal³⁰, Yesim Aybar-Bilir³¹, Hasip Kahraman³⁰, Hrvoje Mikulić³², Saim Dayan³³, Antonio Cascio³⁴, Eray Serdar Yurdakul³⁵, Fatma Colkesen³⁶, Kadriye Karahangil³⁷, Angel Espinosa², Bilal Ahmad Rahimi³⁸, Zdraveski Vangel³⁹

MORTALITY IN SURGICAL SITE INFECTIONS POST-CARDIAC SURGERY – A PROSPECTIVE, INTERNATIONAL ID-IRI STUDY

SUMMARY

Introduction: Surgical site infections (SSIs) after cardiac surgery increase morbidity and mortality. This multi-center study aimed to identify mortality risk factors associated with SSIs following heart surgery.

Methods: Conducted from January to March 2023, this prospective study included 167 patients aged >16 with post-heart surgery SSIs. The primary focus was on 30-day mortality. Univariate analysis and a multivariate logistic regression model, utilizing the Backward elimination method, were employed to establish the final model.

Results: A number of factors had substantial correlations to death. These included urinary catheterization [OR 62.541 (90% CI 1,862-2100.445)], bloodstream infections [OR 19.796 (90% CI 1.294-302.728)], emergent surgery [OR 23.280 (90% CI 2.420-223.929)], valvular replacement [OR 11.967 (90% CI 1.117-128.261)], higher qSOFA scores [OR 5.739 (90% CI 1.342-24.539)], shorter preoperative stays (≤1 day) [OR 0.470 (90% CI 0.258-0.855)], and postoperative re-interventions within 30 days following SSI [OR 39.995 (90% CI 1.851-864.050)]. No pathogen was isolated from wound cultures in 53 (31.7%) patients. 43.1% of SSIs (n=72) were due to Gram-positive microorganisms, while 27.5% of cases (n=46) involved Gram-negatives. Among Gram-positives, Staphylococci (n=30, 17.9%) were the predominant microorganisms, while Klebsiellae (n=16, 9.6%), Escherichia coli (n=9, 5.4%), Pseudomonas aeruginosa (n=7, 4.2%), and were the most prevalent among Gram-negatives. Colonization with VRE, MRSA, carbapenem-resistant enteric bacteria on admission was detected in 9 (6.1%) cases.

Conclusion: To mitigate mortality following heart surgery, stringent infection control measures, preoperative screening, and effective surgical antisepsis are crucial. Timely detection of bloodstream infections and effective treatment are other essential components of SSI management.