Perioperative decontamination care bundle for prevention of nosocomial infection after cardiac surgery

Abstract

Objective To observe the effect of the decontamination bundle of care for prevention of nosocomial infection after cardiac surgery. Methods Patients who underwent routine perioperative care from January 2012 to December 2013 for cardiac surgery were enrolled as the control group, while patients with bundle of care from May 2014 to April 2016 as the decontamination group. The care bundle included preoperative nasopharyngeal screening for methicillin-resistant Staphylococcus aureus (MRSA), perioperative systematic decontamination, isolation and antibiotic prophylaxis (mupirocin and glycopeptide) for MRSA carriers. The clinical data and nosocomial infection was collected and statistically analyzed. Results There were 712 cases in the control group and the incidence of nosocomial infection was 8.29% (59/712) including 4 MRSA cases. The decontamination group enrolled 791 cases with 5.56% (44/791) nosocomial infection including 2 MRSA cases. The bundles of care inhibited the nosocomial infection significantly (χ2=4.356, P<0.05), and there was a trend of decrease on MRSA infection. A total of 6 cases (0.76%) in the decontamination group were detected as MRSA colonization, but none of them got infected. Conclusions The care bundle of perioperative decontamination is useful to prevent nosocomial infection in cardiac surgery, especially to MRSA infection. Key words: Cardiac surgery; Bundles of care; Chlorhexidine; Nosocomial infection; Antibiotic prophylaxis