A prospective study of hospital-acquired infection in 2330 cardiovascular surgery patients.

Between March 1982 and May 1983, 2330 patients undergoing cardiovascular surgery were prospectively surveyed for hospital-acquired infections. During the first month of the study the overall incidence of infection was 8.2%, the incidence of postoperative wound infection was 3.8%, urinary tract infection 3.2%, lower respiratory tract infection 1.2% and bacteraemia 0.6%. In May 1983 the overall incidence was 3.2% and incidence of wound, urinary tract and lower respiratory infections were 1.3%, 0.6% and 1.3% respectively. Urinary tract infection was reduced by substituting a closed drainage system for open drainage. A peak of postoperative wound infection was observed in November 1982 and was related to changes in the functioning of the department resulting in inadequate pre-operative preparation. Two outbreaks of pseudobacteraemia occurred related to the arterial line stopcock and to heparin used for biochemistry tests. Antimicrobial prophylaxis was not modified during the study. However, wound infection rates dropped from 4% to 1.3%. In conclusion, this surveillance programme was associated with a significant reduction in hospital-acquired infection.