Suppurative XXXX after open-heart surgery: a comparison between cases caused by Gram-negative rods and by Gram-positive cocci.

@entity1 @entity281 @entity1764 @entity293
OBJECTIVE: To compare clinical characteristics and risk factors of suppurative postsurgical @entity1764 according to its etiology. METHODS: Suppurative postsurgical @entity1764 developed in 45 (2.5%) of 1779 @entity1 who underwent open-heart surgery at the Hospital Virgen del Roc  o in Seville, Spain, from 1986 to 1996. Microbiological diagnosis was available in 42 @entity1 . RESULTS: Gram-negative rods were isolated in 19 cases and Gram-positive cocci in 23 cases. Seventeen isolates (38%) were sensitive to the antimicrobial agent used perioperatively. @entity1 with Gram-negative @entity281 had a longer duration of bypass (127plus minus36 min versus 96plus minus34 min, p<0.01), and a worse postoperative condition. Longer mechanical ventilation (4plus minus7 days versus 1plus minus2 days, p<0.05) and concomitant infection in a remote site (pulmonary and/or @entity293 ) were more frequently observed in this group than in @entity1 with Gram-positive @entity281 (58% versus 22%, p<0.05). Twenty @entity1 (51%) were bacteremic. The mortality rate was 20% (five of 45). CONCLUSIONS: Preventable postoperative remote-site infection may lead to @entity1764 , especially if Gram-negative rods are involved.
