Investigation of fungal nosocomial infections and antimicrobial drug resistance pattern after open-heart surgery; a cross-sectional study.
Narges Lashkarbolouk, Mahdi Mazandarani, Mohammad Taher Hojjati, Seyedeh Sedigheh Hosseini
Abstract
Open AccessBackground: Nosocomial fungal infections are a significant cause of mortality in hospitalized patients, particularly those with immune system defects. Surgical site infections (SSIs) following open-heart procedures cause significant problems for patients and treatment systems. Methods: In this cross-sectional study, we analyzed wound culture samples from the sternum, urine cultures, blood cultures, and cultures from catheters of 310 hospitalized patients (mean age: 42 ± 10.23 years), collected between March 2018 and February 2022. Antimicrobial susceptibility tests were conducted using the Kirby-Bauer diffusion disk method. We assessed antimicrobial resistance alongside laboratory indicators related to infections. Results: The highest rate of infection was urinary tract infection (13.54%) septicemia (10%), pneumonia (4.83%), SSIs (3.87%), and catheter-induced infection (1.29%), respectively. The mortality rate was 6.4%. All fungal strains were Candida spp., and six strains were resistant to fluconazole. All Candida species were sensitive to amphotericin B. The highest amount of antibiotic resistance is related to ceftazidime (51.3%), followed by ceftriaxone (43.2%), and the lowest amount is related to nitrofurantoin and sulfamethoxazole/trimethoprim (17.6%). Conclusions: The non-Candida albicans species were the most abundant species identified in candidiasis. Cardiovascular diseases, chronic kidney disease, hypertension, diabetes, and obesity increase the rate of SSI in patients.