Impact of Diabetes and Blood Glucose Control on Surgical Site Infections in Cardiac Surgery

Abstract

Introduction: Surgical site infection is an important morbidity in cardiac surgery. Purpose of this study is to compare surgical site infections after surgery in our center in diabetic and non-diabetic patients. Patients and Methods: Surgical site infections and the responsible microorganisms after cardiac operations from January to December 2011 were documented. Patients were aligned in to four Groups; 16 patients with known diabetes were Group I, 22 patients with preoperative hyperglycemia but without known diabetes were Group II, 8 patients with postoperative hyperglycemia were Group III and 14 patients with normal pre and postoperative blood glucose levels were Group IV. Infections were classifi ed according to Centers for Disease Control and Prevention (CDC) guidelines. Results: Surgical wound infections were detected in 60 patients. Organ/space type surgical infections were more common in Group I and III, compared to patients in Group II and IV, among whom, deep wound infections were more common. Methicillin resistant Staphylococcus aureus and Acinetobacter baumannii were more prominant in Group II and III, where as Klebsiella spp. and Serratia spp. Were more common in Group I patients. Mortality rate was highest in Group II (59%), followed by Group I (38%). Mortality in Group III was 25% and 21.4% in Group IV, with a statistically important difference compared to Group II (p= 0.02). Conclusion: High blood glucose level that can not be regulated in preoperative and postoperative periods, is an important risk factor for surgical site infections. Strict control of blood glucose levels in diabetic patients, is believed to decrease infection prevalence and asssociated hospital mortality.