fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2025-10-1-23-28fcmedicine-967Research ArticleЭПИДЕМИОЛОГИЯEPIDEMIOLOGYФакторы риска инфекций кровотока у пациентов кардиохирургического и нейрохирургического профиляRisk factors for bloodstream infections in cardiac and neurosurgery patientshttps://orcid.org/0000-0002-4335-0962СадовниковЕ. Е.SadovnikovE. E.

Садовников Евгений Евгеньевич , врач-эпидемиолог

Бульвар имени академика Л.С. Барбараша, 6, г. Кемерово, 650002

Dr. Evgeny E. Sadovnikov И, MD, Epidemiologist

Barbarash Boulevard, 6, Kemerovo, 650002

evsadov1@gmail.comhttps://orcid.org/0009-0003-4975-8795ГридинаА. А.GridinaA. A.

Гридина Анна Александровна, врач-эпидемиолог

Бульвар имени академика Л.С. Барбараша, 6, г. Кемерово, 650002

Dr. Anna A. Gridina, MD, Epidemiologist

Barbarash Boulevard, 6, Kemerovo, 650002

Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеванийРоссияResearch Institute for Complex Issues of Cardiovascular DiseasesRussian Federation2025250320251012328Copyright © Садовников Е.Е., Гридина А.А., 20252025Садовников Е.Е., Гридина А.А.Sadovnikov E.E., Gridina A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/967Цель

Цель. Выявить факторы риска инфекций кровотока у пациентов нейрохирургического и кардиохирургическо­го профиля.

Материалы и методы

Материалы и методы. Выполнено сплош­ное комбинированное ретроспективное (2018 - 2019гг.) и проспективное (2020 - 2022 гг.) аналитическое эпидеми­ологическое исследование типа «случай-контроль» ис­ходов лечения пациентов (n = 6068). Всего было изуче­но 16 факторов риска присоединения инфекции крово­тока. Для оценки риска применялся показатель отноше­ния шансов с расчётом 95% доверительного интервала.

Результаты

Результаты. Из 16 изученных факторов риска 3 не ока­зывали влияния на развитие инфекции. Процедура кате­теризации центральных вен более 48 часов сопровожда­лась риском присоединения катетер-ассоциированных инфекций кровотока (КАИК) и была в 1,20 раза выше у кардиохирургических пациентов. Проведение ЭКМО повышало вероятность развития инфекции кровотока в 14 раз (ОШ = 14,18, 95% ДИ [5,17 - 39,13], p < 0,001). Фак­торами риска присоединения инфекции кровотока у ней­рохирургических пациентов выявлены: наличие пневмо­нии при госпитализации и степень нарушения сознания; у кардиохирургических пациентов - развитие синдрома полиорганной недостаточности, прием антимикробных препаратов, госпитализация в предыдущие три месяца, возраст старше 65 лет и длительность пребывания в отде­лении реанимации более 3 суток.

Заключение

Заключение. Выявлен­ные факторы риска КАИК должны быть учтены в систе­ме обеспечения эпидемиологической безопасности ме­дицинских организаций.

Aim

Aim. To identify risk factors for bloodstream infections in patients admitted to cardiac surgery and neurosurgery units.

Materials and Methods

Materials and Methods. We conducted a comprehensive combined retrospective (2018-2019) and prospective (2020­2022) case-control study which analysed treatment outcomes in 6,068 patients and examined 16 risk factors of bloodstream infections.

Results

Results. Out of 16 studied risk factors, three had no impact on bloodstream infection development. Central venous catheterization for > 48 hours was associated with an increased risk of catheter-related bloodstream infections (1.2-fold in patients admitted to cardiac surgery units). Extra­corporeal membrane oxygenation dramatically increased the risk of bloodstream infections (OR = 14.18, 95% CI [5.1739.13], p < 0.001). In patients admitted to neurosurgery units, bloodstream infection risk factors included pneumonia at the admission and the degree of consciousness impairment. In cardiac surgery patients, risk factors included multiple organ failure, antimicrobial therapy prior to the admission, hospi­talization within the previous 3 months, age > 65 years, and an intensive care unit stay > 3 days.

Conclusion

Conclusion. Identified risk factors of bloodstream infections should be considered in the epidemiological safety framework of healthcare insti­tutions.

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The authors declare that there are no conflicts of interest present.