Distribution of pathogenic bacteria and influencing factors for nosocomial infection after cardiovascular surgery

WEI Wen-ke; LIU Jia-di; JING Yu-chen; HAN Ying

doi:10.11659/jjssx.04E025162

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Distribution of pathogenic bacteria and influencing factors for nosocomial infection after cardiovascular surgery

Clinical Research | 更新时间：2026-01-19

- Distribution of pathogenic bacteria and influencing factors for nosocomial infection after cardiovascular surgery
- JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY Vol. 35, Issue 1, Pages: 57-61(2026)
- 作者机构：
  
  1.中国医科大学附属第一医院心脏外科，辽宁沈阳 110001
  2.中国医科大学附属第一医院急诊科，辽宁沈阳 110001
  3.中国医科大学附属第一医院血管外科/甲状腺外科，辽宁沈阳 110001
- 作者简介：
- 基金信息：
- DOI：10.11659/jjssx.04E025162
  CLC： R825.4
- Received：30 April 2025，
  
  Published：25 January 2026
- 稿件说明：
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魏文珂,刘家娣,荆玉辰等.心脏大血管手术后院内感染致病菌分布及影响因素研究[J].局解手术学杂志,2026,35(01):57-61.

WEI Wen-ke,LIU Jia-di,JING Yu-chen,et al.Distribution of pathogenic bacteria and influencing factors for nosocomial infection after cardiovascular surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(01):57-61.
魏文珂,刘家娣,荆玉辰等.心脏大血管手术后院内感染致病菌分布及影响因素研究[J].局解手术学杂志,2026,35(01):57-61. DOI： 10.11659/jjssx.04E025162.

WEI Wen-ke,LIU Jia-di,JING Yu-chen,et al.Distribution of pathogenic bacteria and influencing factors for nosocomial infection after cardiovascular surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(01):57-61. DOI： 10.11659/jjssx.04E025162.

摘要

目的

探讨心脏大血管手术后院内感染的致病菌分布情况及其影响因素。

方法

回顾性分析2022年1月至2025年1月在我院行心脏大血管手术后发生院内感染的158例患者（感染组）的临床资料，另基于匹配设计的病例对照研究回顾性分析同期在我院行心脏大血管手术后未发生院内感染的158例患者（非感染组）的临床资料。统计心脏大血管手术后院内感染的位置及致病菌分布情况，并分析心脏大血管手术后院内感染的影响因素。

结果

158例术后院内感染患者以呼吸道感染（60.76%）为主，其次为手术部位感染（14.56%）、血行感染（10.76%）。158例院内感染患者共检出病原菌271株，其中以革兰阴性菌占比最高（61.62%），主要为鲍曼不动杆菌（17.71%）、肺炎克雷伯菌（13.65%）；其次为革兰阳性菌（31.37%），以金黄色葡萄球菌（12.92%）为主。多因素

Logistic

回归分析显示，左心室射血分数（LVEF）

50%、手术时间

5 h、术中体外循环时间≥150 min、术中输血量≥1 500 mL、术后抗菌药物联用、术后呼吸机使用时间

3 d、术后引流管留置时间

7 d、二次手术、术后住院时间

20 d均是心脏大血管手术后院内感染的危险因素（

0.05）。

结论

心脏大血管手术后院内感染主要发生在呼吸道，致病菌以革兰阴性菌为主。LVEF较低、术中输血量大、术后抗菌药物联用、二次手术以及手术时间、术中体外循环时间、术后呼吸机使用时间、术后引流管留置时间、住院时间较长的患者在心脏大血管手术后更易发生院内感染。

Abstract

Objective

To investigate the distribution of pathogenic bacteria and influencing factors for nosocomial infection after cardiovascular surgery.

Methods

The clinical data of 158 patients who developed nosocomial infection after cardiovascular surgery （the infection group）in our hospital from January 2022 to January 2025 were retrospectively analyzed， and the clinical data of 158 patients who underwent cardiovascular surgery while without nosocomial infection after surgery （non infection group）in our hospital during the same period based on a matched case-control study design were retrospectively analyzed. The site and distribution of pathogenic bacteria after cardiovascular surgery were counted， and the influencing factors of nosocomial infection after cardiovascular surgery were analyzed.

Results

Among 158 patients with postoperative nosocomial infections， respiratory infection was the most common （60.76%）， followed by surgical site infection （14.56%） and hematogenous infection （10.76%）.A total of 271 strains of pathogenic bacteria were isolated in 158 patients with nosocomial infections， among which Gram-negative bacteria accounted for the highest proportion （61.62%），primarily Acinetobacter baumannii （17.71%） and Klebsiella pneumoniae （13.65%）； followed by Gram-positive bacteria （31.37%），with Staphylococcus aureus （12.92%）being the most common.The results of multiple

Logistic

regression analysis showed that left ventricular ejection fraction （LVEF）

50%，surgery time

5 hours， intraoperative extracorporeal circulation time≥150 minutes， intraoperative blood transfusion volume≥1 500 mL，postoperative use of multiple antibiotics， postoperative ventilator use time

3 days， postoperative drainage tube retention time

7 days， secondary surgery and postoperative hospital stay

20 days were all risk factors for nosocomial infection after cardiovascular surgery （

0.05）.

Conclusion

Nosocomial infections after cardiovascular surgery predominantly affect the respiratory tract and are mainly caused by Gram-negative pathogen. Patients with low LVEF， large intraoperative blood transfusion volume，postoperative use of multiple antibiotics， secondary surgery， as well as prolonged surgery time， intraoperative extracorporeal circulation time， postoperative ventilator use time， postoperative drainage tube retention time， hospital stay are more susceptible to nosocomial infections after cardiovascular surgery.

关键词

Keywords

references

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