Risk factors for bloodstream infections in cardiac and neurosurgery patients
https://doi.org/10.23946/2500-0764-2025-10-1-23-28
Abstract
Aim. To identify risk factors for bloodstream infections in patients admitted to cardiac surgery and neurosurgery units.
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. 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. Identified risk factors of bloodstream infections should be considered in the epidemiological safety framework of healthcare institutions.
About the Authors
E. E. Sadovnikov
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Dr. Evgeny E. Sadovnikov И, MD, Epidemiologist
Barbarash Boulevard, 6, Kemerovo, 650002
A. A. Gridina
Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation
Russian Federation
Dr. Anna A. Gridina, MD, Epidemiologist
Barbarash Boulevard, 6, Kemerovo, 650002
References
1. Gatos C, Fotakopoulos G, Chatzi M, Georgakopoulou VE, Spandidos DA, Makris D, Fountas KN. Investigation of risk factors for external ventricular drainage associated central nervous system infections in patients undergoing neurosurgery. Medicine international. 2023;3(5):44. https://doi.org/10.3892/mi.2023.104
2. Golukhova EZ, Semenov VYu, Milievskaya EB, Pryanishnikov VV. Provision of high-tech cardiovascular care to residents of the russian federation regions in 2021. Complex Issues of Cardiovascular Diseases. 2023;12(2):77-87. (In Russian.) https://doi.org/10.17802/2306-1278-2023-12-2-77-87
3. Ferreira GB, Donadello JCS, Mulinar L.A. Healthcare-Associated Infections in a Cardiac Surgery Service in Brazil. Brazilian journal of cardiovascular surgery. 2020;35(5):614-618. https://doi.org/10.21470/1678-9741-2019-0284
4. Abulhasan YB, Abdullah AA, Shetty SA, Ramadan MA, Yousef W, Mokaddas EM. Health Care-Associated Infections in a Neurocritical Care Unit of a Developing Country. Neurocritical care. 2020;32(3):836- 846. https://doi.org/10.1007/s12028-019-00856-8
5. Huang YH, Lee TH. Health care-associated infections after surgical treatment of ruptured intracranial aneurysms. Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association. 2024;33(6):107725. https://doi.org/10.1016/j.jstrokecerebrovasdis.2024.107725
6. Sergevnin VI, Kudryavtseva LG, Zolotukhina AI. Frequency and Risk Factors of Purulent Septic Infection among Adults after Different Types of an Open Heart Operations. Epidemiology and Vaccinal Prevention. 2020;19(5):34-40. (In Russian). https://doi.org/10.31631/2073-3046-2020-19-5-34-40
7. Toor H, Farr S, Savla P, Kashyap S, Wang S, Miulli DE. Prevalence of Central Line-Associated Bloodstream Infections (CLABSI) in Intensive Care and Medical-Surgical Units. Cureus. 2022;14(3):e22809. https://doi.org/10.7759/cureus.22809
8. Goda R, Sharma R, Borkar SA, Katiyar V, Narwal P, Ganeshkumar A, Mohapatra S, Suri A, Kapil A, Chandra PS, Kale SS. Frailty and Neutrophil Lymphocyte Ratio as Predictors of Mortality in Patients with Catheter-Associated Urinary Tract Infections or Central LineAssociated Bloodstream Infections in the Neurosurgical Intensive Care Unit: Insights from a Retrospective Study in a Developing Country. World neurosurgery. 2022;162:e187-e197. https://doi.org/10.1016/j.wneu.2022.02.115
9. Busl KM. Healthcare-Associated Infections in the Neurocritical Care Unit. Current neurology and neuroscience reports. 2019;19(10):76. https://doi.org/10.1007/s11910-019-0987-y
10. Pereira AG, Lopes JM, Pereira LCS, Bragato AGDC, Araújo SA, Figueiredo VN, Haas VJ, Raponi MBG. Factors associated with surgical site infection in myocardial revascularization: a retrospective longitudinal study. Revista brasileira de enfermagem. 2023;76Suppl 4(Suppl 4):e20230108. https://doi.org/10.1590/0034-7167-2023-0108
11. Brusina EB, Zuyeva LP, Kovalishena OV, Stasenko VL, Feldblium IV, Briko NI, Akimkin VG. Healthcare-Associated Infections: Modern Doctrine of Prophylaxis. Part II. Basic Concept. Epidemiology and Vaccinal Prevention. 2018;17(6):4-10. (In Russian). https://doi.org/10.31631/2073-3046-2018-17-4-10
12. Kolyado EV, Peleganchuk VA, Shults TE, Povalikhin AN, Lazareva VV. Organization of work with undesired events within the system of medical activities quality and safety internal control with the use of digital technology. Acta Biomedica Scientifica. 2023;8(1):218-227. https://doi.org/10.29413/ABS.2023-8.1.22
13. Blo S, Ruppé E, Harbarth S, Asehnoune K, Poulakou G, Luyt CE, Rello J, Klompas M, Depuydt P, Eckmann C, Martin-Loeches I, Povoa P, Bouadma L, Timsit JF, Zahar JR. Healthcare-associated infections in adult intensive care unit patients: Changes in epidemiology, diagnosis, prevention and contributions of new technologies. Intensive & critical care nursing. 2022;70:103227. https://doi.org/10.1016/j.iccn.2022.103227
14. Moriyama K, Ando T, Kotani M, Tokumine J, Nakazawa H, Motoyasu A, Yorozu T. Risk factors associated with increased incidences of catheter-related bloodstream infection. Medicine. 2022;101(42):e31160. https://doi.org/10.1097/MD.0000000000031160
15. Buetti N, Marschall J, Drees M, Fakih MG, Hadaway L, Maragakis LL, Monsees E, Novosad S, O'Grady NP, Rupp ME, Wolf J, Yokoe D, Mermel LA. Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update. Infection control and hospital epidemiology. 2022;43(5):553-569. https://doi.org/10.1017/ice.2022.87
16. Plotnikov GP, Geise AV, Grigoriev EV, Kudryavtsev AN, Radivilko AS, Sashurina LP, Shukevich DL. Persistent multi-organ failure: theory and clinical examples (discussion materials). High-Tech Medicine. 2020;7(3):10-17.
17. Zukowska A, Zukowski M. Surgical Site Infection in Cardiac Surgery. Journal of clinical medicine. 2022;11(23):6991. https://doi.org/10.3390/jcm11236991
18. Shevchenko YuL, Susov RP. Postoperative infectious and inflammatory appointments in cardiothoracic surgery. Bulletin of the event of the Medical and Surgical Center named after NI Pirogov. 2022;17(1):84- 89. https://doi.org/10.25881/20728255_2022_17_1_84
19. Zhang L, Li X, Huang J, Yang Y, Peng H, Yang L, Yu X. Predictive model of risk factors for 28-day mortality in patients with sepsis or sepsis-associated delirium based on the MIMIC-IV database. Scientific reports. 2024;14(1):18751. https://doi.org/10.1038/s41598-024-69332-4
20. Rafa E, Kołpa M, Wałaszek MZ, Domański A, Wałaszek MJ, Różańska A, Wójkowska-Mach J. Healthcare-Acquired Infection Surveillance in Neurosurgery Patients, Incidence and Microbiology, Five Years of Experience in Two Polish Units. International journal of environmental research and public health. 2022;19(12):7544. https://doi.org/10.3390/ijerph19127544
Review
For citations:
Sadovnikov E.E., Gridina A.A. Risk factors for bloodstream infections in cardiac and neurosurgery patients. Fundamental and Clinical Medicine. 2025;10(1):23-28. (In Russ.) https://doi.org/10.23946/2500-0764-2025-10-1-23-28
Views:
169
Email this article 