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On prevention of postoperative infectious complications in high-tech surgery. Status of problem

Abstract

Background. The health care-associated infection in the hospital unit is one of the most important causes of morbidity and mortality in high-tech surgery and transplantology. Objectives. Analysis of special literature devoted to the problem of health care-associated infections and the importance of its prevention measures for patients of surgical departments, as well as the role of the bacterial state of the skin as an independent risk factor for postoperative bacteremia and mortality (based on our own findings). Methods. Analysis of the literature provided by PubMed resource in the period from year 2015 to 2017 on the relevant issues. A retrospective analysis of daily blood samples and swabs from the skin of patients after heart transplantation in the period from year 2013 to 2017. The criterion of group separation - the presence or absence of skin contamination. Results. 45 articles were selected. According to own data, 87 (76.3 %) of 114 cases of contamination were registered in the intensive care unit. The mortality and bacterial blood infection levels in the case of skin contamination were significantly higher (p < 0.05). Conclusions. Constant routine skin monitoring of its bacteriological condition is a necessary measure to reduce infectious complications.

About the Authors

S. O. Sharapchenko
Federal Research Centre for Transplantology and Artificial Organs n.a. academician V.I. Shumakov
Russian Federation


N. I. Gabrielyan
Federal Research Centre for Transplantology and Artificial Organs n.a. academician V.I. Shumakov
Russian Federation


R. Sh. Saitgareev
Federal Research Centre for Transplantology and Artificial Organs n.a. academician V.I. Shumakov
Russian Federation


V. M. Zakharevich
Federal Research Centre for Transplantology and Artificial Organs n.a. academician V.I. Shumakov
Russian Federation


I. V. Drabkina
Federal Research Centre for Transplantology and Artificial Organs n.a. academician V.I. Shumakov
Russian Federation


N. M. Esenova
Federal Research Centre for Transplantology and Artificial Organs n.a. academician V.I. Shumakov
Russian Federation


L. Yu. Romashkina
Federal Research Centre for Transplantology and Artificial Organs n.a. academician V.I. Shumakov
Russian Federation


T. B. Safonova
Russian Medical Academy for Continuing Professional Education
Russian Federation


M. I. Petrukhina
Russian Medical Academy for Continuing Professional Education
Russian Federation


L. G. Stolyarova
Russian Medical Academy for Continuing Professional Education
Russian Federation


G. N. Mel’Nikova
Scientific and Research Institute for Disinfectology
Russian Federation


References

1. Sari B., Baran I., Alagam S, Mumcuoglu I., Kurşun Ş, Aksu N. Investigation of oxacilli-nase genes in nosocomial multidrug-resistant Acinetobacter baumannii isolatesby multiplex PCR and evaluation of their clonal relationship with Rep-PCR. // Mikrobiyol Bul.- 2015 Apr; 49 (2): 249-58.

2. Pierri M.D., Crescenzi G., Capestro F., Recanatini C., Manso E., D’errico M.M., Prospero E., Barbadoro P., Torracca L. Risk Factors and Impact on Clinical Outcome of Multidrug-Resistant Acinetobacter BaumanniiAc-quisition in Cardiac Surgery Patients. // J Cardiothorac Vasc Anesth.-2015 Aug 24; pii: S 1053-0770(15)00801-0. doi: 10.1053/j.jvca.2015.08.024.

3. Al-Otaibi F.E., Bukhari E.E., Badr M., Alrabiaa A.A. Prevalence and risk factors of Gramnegative bacilli causing blood stream infection in patients withmalignancy. // Saudi Med J.-2016 Sep; 37 (9): 79-84. doi: 10.15537/smj.2016.9.14211

4. Lanini I., Costa A.N., Puro V., Procaccio F., Grossi P.A., Vespasiano F., Ricci A., Vesconi I., Ison M.G., Carmeli Y., Ippolito G., Donor-Recipient Infection (DRIn) Collaborative Study Group. Incidence of carbapenem-resistant gram negatives in Italian transplant recipients: a nationwidesurveillance study. // PLoS One.- 2015 Apr 2; 10 (4): e0123706

5. Lin M.F., Tsai P.W., Chen J.Y., Lin Y.Y., Lan C.Y. OmpA Binding Mediates the Effect of Antimicrobial Peptide LL-37 on Acinetobacter baumannii. // PLoS One.-2015 Oct 20; 10 (10): e0141107.

6. Kawecki D., Pacholczyk M., Lagiewska B., Sawicka-Grzelak A., Durlik M., Mlynarczyk G., Chmura A. Bacterial and fungal infections in the early post-transplantation period after liver transplantation: etiologic agents and their susceptibility. // Transplant Proc. - 2014 Oct; 46 (8): 2777-81

7. Ferstl P.G., Filmann N., Brandt C., Zeuzem I., Hogardt M., Kempf V.A., Muller M., Waidmann O., Reinheimer C. The impact of carbapenem resistance on clinical deterioration and mortality in patients with liver disease. // Liver Int.-2017 Apr 4; doi: 10.1111/liv.13438.

8. Ghajavand H., Esfahani B.N., Havaei S.A., Moghim I., Fazeli H. Molecular identification of Acinetobacter baumannii isolated from intensive care units and theirantimicrobial resistance patterns. // Adv Biomed Res.- 2015 May 29; 4:110. doi: 10.4103/2277-9175.157826.

9. Vasudevan A., Mukhopadhyay A., Li J., Yuen E.G., Tambyah P.A. A prediction tool for nosocomial multi-drug Resistant Gram-Negative Bacilli infections in critically ill patients prospective observational study. // BMC Infect Dis.-2014 Nov25; 14: 615. doi: 10.1186/s12879-014-0615-z.

10. Perni I., Thenault V., Abdo P., Margulis K., Magdassi I., Prokopovich P. Antimicrobial activity of bone cements embedded with organic nanoparticles. // Int J Nanomedicine.-2015 Oct 12; 10: 6317-29.

11. Lee C.S., Vasoo I., Hu F., Patel R., Doi Y. Klebsiella pneumoniae ST147 coproducing NDM-7 carbapenemase and RmtF 16S rRNAmethyltransferase in Minnesota. // J Clin Microbiol.-2014 Nov; 52 (11): 4109-10.

12. Çigek M., Hasgelik G., Muştak H.K., Diker K.S., Şener B. Accurate diagnosis of Pseu-domonas luteola in routine microbiology laboratory: on the occasion of two isolates. // Mikrobiyol Bul. - 2016 Oct; 50 (4): 621-624.

13. Rossi F., Girardello R., Cury A.P., Di Gioia T.S., Almeida J.N. Jr., Duarte AJ. Emergence of colistin resistance in the largest university hospital complex of Sao Paulo, Brazil, over five years. // Braz J Infect Dis.-2017 Jan-Feb; 21 (1): 98-101. doi: 10.1016/j.bjid.2016.09.011.

14. Li X., Quan J., Yang Y., Ji J., Liu L., Fu Y., Hua X., Chen Y., Pi B., Jiang Y., Yu Y. Abrp, a new gene, confers reduced susceptibility to tetracycline, glycylcine, chloramphenicol and fosfomycin classes in Acinetobacter baumannii. // Eur J Clin Microbiol Infect Dis.- 2016 Aug; 35 (8): 1371-5. doi: 10.1007/s10096-016-2674-0.

15. Lei J., Han I., Wu W., Wang X., Xu J., Han L. Extensively drug-resistant Acinetobacter baumannii outbreak cross-transmitted in an intensive care unit and respiratory intensive care unit. // Am J Infect Control.-2016 Nov 1; 44 (11): 1280-1284. doi: 10.1016/j.ajic.2016.03.041.

16. Chen Q., Cao H., Lu H., Qiu ZH., He JJ. Bi-oprosthetic tricuspid valve endocarditis caused by Acinetobacter baumannii complex, a case report and brief review of the literature. // J Cardiothorac Surg.-2015 Nov 4; 10: 149. doi: 10.1186/s13019-015-0377-8.

17. Richmond G.E., Evans L.P., Anderson M.J., Wand M.E., Bonney L.C., Ivens A., Chua K.L., Webber M.A., Sutton J.M., Peterson M.L., Piddock L.J. The Acinetobacter baumannii Two-Component System AdeRS Regulates Genes Required for Multidrug Efflux, Biofilm Formation, and Virulence in a Strain-Specific Manner. // MBio. - 2016 Apr 19; 7 (2). pii: e00430-16. doi: 10.1128/mBio.00430-16.

18. Skowronek P., Wojciechowski A., Leszczyhski P., Olszewski P., Sibihski M., Polguj M., Synder M. Can diagnostic ultrasound scanners be a potential vector of opportunistic bacterial infection? // Med Ultrason.- 2016 Sep; 18 (3): 326-31. doi: 10.11152/ mu.2013.2066.183.sko.

19. Bingham J., Abell G., Kienast L., Lerner L., Matuschek B. Mullins W., Parker A., Reynolds N., Salisbury D., Seidel J., Young E., Kirk J. Health care worker hand contamination at critical moments in outpatient care settings. // Am J Infect Control.-2016 Nov 1; 44 (11): 11981202. doi: 10.1016/j.ajic.2016.04.208.

20. Greene C., Vadlamudi G., Eisenberg M., Foxman B., Koopman J., Xi C. Fomite-fingerpad transfer efficiency (pick-up and deposit) of Acinetobacter baumannii-with and without a latex glove. // Am J Infect Control.- 2015 Sep 1; 43 (9):928-34. doi: 10.1016/j.ajic.2015.05.008.

21. Chen CH., Lin L.C., Chang Y.J., Chen Y.M., Chang C.Y., Huang C.C. Infection Control Programs and Antibiotic Control Programs to Limit Transmission of Multi-Drug Resistant Acinetobacter baumannii Infections: Evolution of Old Problems and New Challenges for Institutes. // Int J Environ Res Public Health.- 2015 Jul 30; 12 (8): 8871-82. doi: 10.3390/ijerph120808871.

22. Cheng V.C., Chen J.H., Poon R.W., Lee W.M., So S.Y., Wong S.C., Chau P.H., Yip C.C., Wong S.S., Chan J.F., Hung I.F., Ho P.L., Yuen K.Y. Control of hospital endemicity of multiple-drug-resistant Acinetobacter baumannii ST457 with directly observed hand hygiene. // Eur J Clin Microbiol Infect Dis.-2015 Apr 34(4): 713-8. doi: 10.1007/s10096-014-2281-x.

23. Ashfaq A., Zhu A., Iyengar A., Wu H., Humphries R., McKinnell J.A., Shemin R., Benharash P. Impact of an Institutional Antimicrobial Stewardship Program on Bacteriology of Surgical Site Infections in Cardiac Surgery. // J Card Surg.- 2016 Jun; 31 (6): 367-72. doi: 10.1111/jocs.12756.

24. Fresnadillo-Martfnez M.J., Garcia-Merino E., Garcfa-Sanchez E., Martfn-del Rey A., Rodrfguez-Encinas A., Rodrfguez-Sánchez G., Garcfa-Sanchez J.E. Prevention of an outbreak of Acinetobacter baumannii in intensive care units: study of the efficacy ofdifferent mathematical methods. // Rev Esp Quimioter.- 2015 Feb; 28 (1): 10-20.

25. Jiang Y., Resch I., Liu X., Rogers S.O. Jr., Askari R., Klompas M., Jayaraman S.P. The Cost of Responding to an Acinetobacter Outbreak in Critically Ill Surgical Patients. // Surg Infect (Larchmt) - 2016 Feb; 17 (1): 58-64. doi: 10.1089/sur.2015.036.

26. Jayaraman S.P., Jiang Y., Resch S, Askari R., Klompas M. Cost-Effectiveness of a Model Infection Control Program for Preventing Multi-Drug-Resistant Organism Infections in Critically Ill Surgical Patients. Surg Infect (Larchmt).- 2016 Oct; 17 (5): 589-95. doi: 10.1089/sur.2015.222.

27. Birgand G., Leroy C., Nerome S., Luong Nguyen L.B., Lolom I., Armand-Lefevre L.,. Ciotti C., Lecorre B., Marcade G., Fihman V., Nicolas-Chanoine M.H., Pelat C., Perozziello A., Fantin B., Yazdanpanah Y., Ricard J.D., Lucet J.C. Costs associated with implementation of a strict policy for controlling spread of highly resistant microorganisms in France. // BMJ Open.- 2016 Jan 29; 6 (1): e009029. doi: 10.1136/bmjopen-2015-009029.

28. Teerawattanapong N., Kengkla K, Dilok-thornsakul P., Saokaew S., Apisarnthanarak A., Chaiyakunapruk N. Prevention and Control of Multidrug-Resistant Gram-Negative Bacteria in Adult Intensive Care Units: A Systematic Review and Network Meta-analysis. // Clin Infect Dis.- 2017 May 15; 64 (suppl2): S51-S60. doi: 10.1093/cid/cix112.

29. Gray A.P., Allard R., Pare R., Tannenbaum T., Lefebvre B., Levesque S., Mulvey M., Maalouf L., Perna S., Longtin Y. Management of a hospital outbreak of extensively drug-resistant Acinetobacter baumannii using a multimodal intervention including daily chlorhexidine baths. // J Hosp Infect.- 2016 May; 93 (1): 29-34. doi: 10.1016/j.jhin.2015.12.013.

30. Swan J.T., Ashton C.M., Bui L.N., Pham V.P., Shirkey B.A., Blackshear J.E., Bersamin J.B., Pomer R.M., Johnson M.L., Magtoto A.D., Butler M.O., Tran S.K., Sanchez L.R., Patel J.G., Ochoa R.A. Jr, Hai S.A., Denison K.I., Graviss E.A., Wray N.P. Effect of Chlorhexidine Bathing Every Other Day on Prevention of Hospital-Acquired Infections in the Surgical ICU: A Single-Center, Randomized Controlled Trial. // Crit Care Med.- 2016 Oct; 44 (10): 1822-32. doi: 10.1097/CCM.0000000000001820.

31. Shah H.N., Schwartz J.L., Luna G., Cullen D.L. Bathing With 2 % Chlorhexidine Gluconate: Evidence and Costs Associated With Central Line-Associated Bloodstream Infections. // Crit Care Nurs Q. - 2016 Jan-Mar 39 (1): 42-50. doi: 10.1097/CNQ.0000000000000096.

32. Loveday H.P., Wilson J.A., Pratt R.J., Golsorkhi M., Tingle A., Bak A., Browne J., Prieto J., Wilcox M. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. // J Hosp Infect.-2014 Jan; 86 Suppl 1: S 1-70. doi: 10.1016/S 0195-6701 (13) 60012-2.

33. Huang H.P., Chen B., Wang H.Y., He M. The efficacy of daily chlorhexidine bathing for preventing healthcare-associated infections in adult intensive care units. // Korean J Intern Med.-2016 Nov; 31 (6): 1159-1170.

34. Cassir N., Thomas G., Hraiech S., Brunet J., Fournier P.E., La Scola B., Papazian L. Chlorhexidine daily bathing: impact on health care-associated infections caused by gram-negative bacteria. // Am J Infect Control.- 2015 Jun; 43 (6): 640-3. doi: 10.1016/j.ajic.2015.02.010.

35. Musuuza J.S., Roberts T.J., Carayon P., Safdar N. Assessing the sustainability of daily chlor-hexidine bathing in the intensive care unit of a Veteran’s Hospital by examining nurses’ perspectives and experiences. // BMC Infect Dis- 2017 Jan 14; 17 (1): 75. doi: 10.1186/s12879-017-2180-8.

36. Afonso E., Blot K., Blot S. Prevention of hospital-acquired bloodstream infections through chlorhexidine gluconate-impregnated washcloth bathing in intensive care units: a systematic review and meta-analysis of randomised crossover trials. // Euro Surveill- 2016 Nov 17; 21 (46). pii: 30400. doi: 10.2807/1560-7917.ES.2016.21.46.30400.

37. Cassir N., Papazian L., Fournier P.E., Raoult D., La Scola B. Insights into bacterial colonization of intensive care patients’ skin: the effect of chlorhexidine daily bathing. // Eur J Clin Microbiol Infect Dis.-2015 May; 34 (5): 999-1004. doi: 10.1007/s10096-015-2316-y.

38. Denny J., Munro C.L. Chlorhexidine Bathing Effects on Health-Care-Associated Infections. // Biol Res Nurs.- 2017 Mar; 19 (2): 123-136. doi: 10.1177/1099800416654013.

39. Swan J.T., Ashton C.M., Bui L.N., Pham V.P., Shirkey B.A., Blackshear J.E., Bersamin J.B., Pomer R.M., Johnson M.L., Magtoto A.D., Butler M.O., Tran S.K., Sanchez L.R., Patel J.G., Ochoa R.A. Jr, Hai S.A., Denison K.I., Graviss E.A., Wray N.P. Effect of Chlorhexidine Bathing Every Other Day on Prevention of Hospital-Acquired Infections in the Surgical ICU: A Single-Center, Randomized Controlled Trial. // Crit Care Med.- 2016 Oct; 44 (10): 1822-32. doi: 10.1097/CCM.0000000000001820.

40. Duszyhska W., Adamik B., Lentka-Bera K., Kulpa K., Nieckula-Schwarz A., Litwin A., Strózecki L., Kubler AEffect of universal chlorhexidine decolonisation on the infection rate in intensive care patients. Anaesthesiol Intensive Ther.- 2017;49(1):28-33. doi: 10.5603/AIT.2017.0007.

41. Gupta T.T., Karki S.B., Matson J.S., Gehling D.J., Ayan H. Sterilization of Biofilm on a Titanium Surface Using a Combination of Nonthermal Plasma and Chlorhexidine Digluconate. // Biomed Res Int.- 2017; 2017: 6085741. doi: 10.1155/2017/6085741.

42. Chung Y.K., Kim J.S., Lee S.S., Lee J.A., Kim H.S., Shin K.S., Park E.Y., Kang B.S., Lee H.J., Kang H.J. Effect of daily chlorhexidine bathing on acquisition of carbapenem-resistant Acine-tobacter baumannii (CRAB) in the medical intensive care unit with CRAB endemicity // Am J Infect Control.- 2015 Nov; 43(11): 1171-7. doi: 10.1016/j.ajic.2015.07.001.

43. Mendes E.T., Ranzani O.T., Marchi A.P., Silva M.T., Filho J.U., Alves T., Guimaraes T., Levin A.S., Costa S.F. Chlorhexidine bathing for the prevention of colonization and infection with multidrug-resistant microorganisms in a hematopoietic stem cell transplantation unit over a 9-year period: Impact on chlorhexidine susceptibility. // Medicine (Baltimore) - 2016 Nov; 95 (46): e5271.

44. Garrido-Benedicto P., Cueto-Quintana P., Farré-Termens E., Mariné-Cabré M., Riba-Reig J., Molina-Chueca R. Effect of daily cleaning with chlorhexidine on the incidence of contamination of blood cultures in the critical patient. // Enferm Intensiva.-2017 Jul-Sep; 28 (3): 97-104. doi: 10.1016/j.enfi.2016.10.004.

45. Ruiz J., Ramirez P., Villarreal E., Gordon M., Saez I., Rodriguez A., Castaneda M.J., Castellanos-Ortega A. Daily bathing strategies and cross-transmission of multidrug-resistant organisms: Impact of chlorhexidine-impregnated wipes in a multidrug-resistant gram-negative bacteria endemic intensive care unit. // Am J Infect Control.- 2017 - Oct 1; 45 (10): 1069-1073. doi: 10.1016/j.ajic.2017.06.029.

46. Габриэлян Н.И., Горская Е. М., Романова Н.И., Саитгареев Р. Ш. Внешняя среда хирургической клиники и внутрибольничные инфекции (состояние вопроса). // Медицинский алфавит.- 2015.- Т. 1., № 6.- С. 7-12.

47. Габриэлян Н.И., Арефьева Л. И., Горская Е. М., Драбкина И. В., Есенова Н. М., Романова Н.И., Федорова Л. С. К проблеме предупреждения госпитальных инфекций в условиях развития антибиотико-резистентности патогенов. // Дезинфекционное дело.-2015.- № 2.- С. 25-31.

48. Габриэлян Н.И., Горская Е. М., Драбкина И. В., Савостьянова О. А., Ромашкина Л. Ю., Захаревич В. М., Саитгареев Р. Ш. Бактериемии госпитального периода после кардиохирургических операций. // Российский медицинский журнал. - 2015.- Т. 21. - № 5. - С. 17-21.

49. Романова Н.И., Горская Е. М., Есенова Н. М., Захаревич В. М., Саитгареев Р. Ш., Габриэлян Н.И. Микрофлора внешней среды как угроза развития инфекционной патологии у пациентов после ортотопической трансплантации сердца. // Медицинский алфавит. - 2016.- Т. 1, № 6.- С. 47-55.

50. Габриэлян Н.И., Драбкина И. В., Саитгареев Р. Ш., Захаревич В. М., Шарапченко С. О., Петрухина М. И., Сафонова Т. Б. Контаминация кожи пациентов как реальный предиктор послеоперационной инфекции. // Эпидемиология и инфекционные болезни. Актуальные вопросы. - 2018 - № 1. - С. 72-78.


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Sharapchenko S.O., Gabrielyan N.I., Saitgareev R.Sh., Zakharevich V.M., Drabkina I.V., Esenova N.M., Romashkina L.Yu., Safonova T.B., Petrukhina M.I., Stolyarova L.G., Mel’Nikova G.N. On prevention of postoperative infectious complications in high-tech surgery. Status of problem. Medical alphabet. 2018;1(10):9-14. (In Russ.)

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