Invasive device-related infections after heart surgery.

OBJECTIVE: To analyze postoperative infections in critically ill patients undergoing heart surgery. SETTING: Intensive care units (ICUs). DESIGN: An observational, prospective, multicenter study was carried out. PATIENTS: Patients in the postoperative period of heart surgery admitted to the ICU and included in the ENVIN-HELICS registry between 2005 and 2011. MAIN OUTCOME VARIABLES: Mechanical ventilation associated pneumonia (MVP), urinary catheter-related infection (UCI), primary bacteremia (PB), PB related to vascular catheters (PB-VC) and secondary bacteremia. RESULTS: Of a total of 97,692 patients included in the study, 9089 (9.3%) had undergone heart surgery. In 440 patients (4.8%), one or more infections were recorded. Infection rates were 9.94 episodes of MVP per 1000 days of mechanical ventilation, 3.4 episodes of UCI per 1000 days of urinary catheterization, 3.10 episodes of BP-VC per 1000 days of central venous catheter, and 1.84 episodes of secondary bacteremia per 1000 days of ICU stay. Statistically significant risk factors for infection were ICU stay (odds ratio [OR] 1.18, 95%CI 1.16-1.20), APACHE II upon admission to the ICU (OR 1.05, 95%CI 1.03-1.07), emergency surgery (OR 1.67, 95%CI 1.13-2.47), previous antibiotic treatment (OR 1.38, 95%CI 1.04-1.83), and previous colonization by Pseudomonas aeruginosa (OR 18.25, 95%CI 3.74-89.06) or extended spectrum beta-lactamase producing enterobacteria (OR 16.97, 95%CI 5.4-53.2). The overall ICU mortality rate was 4.1% (32.2% in patients who developed one or more infections and 2.9% in uninfected patients) (P < .001). CONCLUSIONS: Of the patients included in the ENVIN-HELICS registry, 9.3% were postoperative heart surgery patients. The overall mortality was low but increased significantly in patients who developed one or more infection episodes.

Fluoride accumulation by plants grown in acid soils amended with flue gas desulphurisation gypsum.

The application of flue gas desulphurisation (FGD) gypsum as an acid soil ameliorant was studied in order to establish the possible detrimental effects on plants and animals feeding on them caused by the high fluoride content in this by-product. A greenhouse experiment was conducted under controlled conditions to determine the F accumulation by two plant species (alfalfa (Medicago sativa L.) and ryegrass (Lolium perenne L.)) grown in acid soils amended with different FGD gypsum doses (0-10%). The F concentrations in plant aerial parts were comprised in the range 22-65 mg kg(-1), and those in plant roots varied from 49 to 135 mg kg(-1). The F contents in the above-ground plant tissues showed to decrease with the FGD gypsum application rate, whereas an inverse trend was manifested by plant roots. The increase in the soil content of soluble Ca as a result of the FGD gypsum addition seemed to play an important role in limiting the translocation of F to plant aerial parts.