الفهرس 
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Abstract
Surgical site infections are a frequent complication following cardiac surgeries. They
are the 2nd most prevalent kind of healthcare-associated infection and a major cause of
morbidity and death after heart surgery.
One important path is infection during surgery, which is measured according to host
infection in surgical patients. Such as cardiac surgery clean as long as no contaminated
viscera was opened during surgery.
SSIs are infections that arise from a surgical site and are categorised as superficial or
deep depending on the incision location, while more serious SSIs may encompass organs or
implanted cardiac devices and materials.
The goal was to identify the prevalence of SSIs after cardiac surgeries directed in the
cardiology department in Alexandria University Hospital and to define the types of
microorganisms involved in the infections and their antimicrobial susceptibility and to inspect
different risk factors involved.
A total of 576 patient medical records were studied and patients’ demographic data and
antimicrobial susceptibility testing results were collected.
It proved that 46 patients (8%) acquired microbiologically documented SSIs. Of which,
deep SSIs were uncommon (6.5%). A total of 52 microbial isolates were reported among
them. Gram(-ve) were the most prevalent pathogens (92.3 %), followed by Gram(+ve) and
fungus (3.8 % each). The predominant pathogenic species were Klebsiella pneumoniae and
Acinetobacter baumannii, both of which showed varying levels of antibiotic resistance, with
the majority of them exhibiting multidrug resistance.
7.2. Conclusions
Although SSIs are considered to be one of the most preventable HAIs, they remain a
leading cause of postoperative morbidity and mortality in cardiac surgery. The overall
rate of SSI in this study was approximately 8%.
The incidence of SSI among adult 9.44% was higher than pediatrics 3%.
During the one-year period of the study, the mortality rate was estimated as 19% and
11% in pediatrics and adults respectively.
During the study period, all pediatric patients 100% encountered superficial SSIs only
651 while 6.5% of adults encountered deep SSIs following CABG surgery while 65%
superficial SSIs among CABG surgery.
Diabetes Mellitus, as a common comorbidity, was observed in more than half of our
patients with SSIs.
Common co-morbidities such as hypertension, diabetes mellitus (DM) and obesity.
were statistically significant across four different study groups.
Gram negative bacteria predominate bacteria pathogen isolated mainly K. pneumonia,
P. aeruginosa.
Overall, the rate of mono-infection detection was significantly higher (77%) than dualinfection
(23%).
7.3. Recommendations
Further studies to identify the source of the nosocomial isolated organisms.
Implementation of proper antibiotic stewardship to overcome the MDR and XDR
organism.
Implementation of pre, intra, post operative, measures to CDC and national guidelines.
Systematic screening and decolonization of S. aureus is not recommended prior to
general surgery.
Decolonization of S. aureus with mupirocin before surgery to minimize occurrence of
SSI and use it in the nose and under axillary for five days before operation with bath of
full body daily for 5 days.
Surgical hand hygiene First hygiene of the day with soapy solution.
Maintain suitable Ventilation and temperature in the operating room
Perform skin preparation with antiseptic agent in concentric circles moving toward the
periphery The prepared area must be large enough to extend the incision or create new
incisions or drain sites
Antiseptics for the preparation of the surgical field Alcohol-based antiseptic
Suture material coated with antiseptic its use is recommended if available.
Cleaning and disinfection of environmental surfaces.
Assemble sterile equipment and solutions immediately prior to use.
Follow CDC infection control guide lines preoperative ,intraoperative and postoperative
to prevent SSIs