[Prevention of post-operative infection in heart surgery with extracorporeal circulation (apropos of 295 cases)].
From April 1977 to November 1978, 295 patients were operated on using artificial circulation. 31 p. 100 of these developed a post-operative infectious complication, 7.3 p. 100 being of a serious nature (3.3 p. 100 suffered from mediastinitis, and 4 p. 100 from septicaemia). The organisms responsible are, in the case of the mediastinal infections the staphylococcus Citreus, and Gram negative bacilli in the case of the septicaemias. A retrospective analysis shows that there are two successive periods and that in the course of the second there is a decrease in the occurence of all of the infections and particularly in the cases of mediastinitis. This improvment would seem on superficial analysis to correspond with a change in the preventive antibiotic treatment, the cephradine--gentamicin combination having replaced penicillin G. However, the statistical study shows that other factors were altered between the two periods (type of antiseptic, duration of treatments, time of postoperative intubation) and that these equally contributed to the fall in the incidence of infection. In the light of this study, it would seem that if prophylactic antibiotic treatment essentially directed against staphylococci has a place in cardiac surgery with artificial circulation, it can only be regarded as one of several preventive factors. The statistical data gathered so far is not sufficient to prove the efficacy of this treatment.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001207:Asepsis; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D002515:Cephradine / Q000627:therapeutic use; D003428:Cross Infection / Q000517:prevention & control*; D005112:Extracorporeal Circulation; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000209:etiology / Q000517:prevention & control; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use; D011183:Postoperative Complications / Q000517:prevention & control*; D018805:Sepsis / Q000209:etiology / Q000517:prevention & control
D005839:Gentamicins; D002515:Cephradine; D010400:Penicillin G
Prévention de l'infection post-opératoire en chirurgie cardiaque sous circulation extra-corporelle (C.E.C.) (à propos de 295 observations).