{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:33:06Z","timestamp":1772253186704,"version":"3.50.1"},"reference-count":41,"publisher":"Sociedade Brasileira de Cardiologia","issue":"4","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Bras. Cardiol."],"abstract":"<jats:p>Resumo  Fundamentos  Embora as infec\u00e7\u00f5es do s\u00edtio cir\u00fargico (ISCs) esternal ap\u00f3s cirurgias card\u00edacas sejam uma importante complica\u00e7\u00e3o, os preditores de falha terap\u00eautica s\u00e3o pouco estudados.  Objetivos  Avaliar preditores cl\u00ednicos e microbiol\u00f3gicos de falha terap\u00eautica de ISC esternal.  M\u00e9todos  Pacientes que apresentaram uma ISC esternal foram retrospectivamente analisados. Foram avaliados dados relacionados a caracter\u00edsticas demogr\u00e1ficas, achados cl\u00ednicos, achados laboratoriais e radiol\u00f3gicos iniciais e tratamento da ISC \u00edndice. O desfecho prim\u00e1rio foi falha terap\u00eautica, incluindo relapso da infec\u00e7\u00e3o (ISC esternal cl\u00ednica ap\u00f3s conclus\u00e3o do tratamento) ou persist\u00eancia da infec\u00e7\u00e3o (falha no tratamento ambulatorial com antimicrobiano). A microbiologia foi avaliada na infec\u00e7\u00e3o \u00edndice e no desfecho. Valores de p &lt; 0,05 foram considerados estatisticamente significativos.  Resultados  Entre os 489 pacientes inclu\u00eddos, a idade m\u00e9dia foi 58 anos, 265 (55%) eram do sexo feminino, 185 (38%) apresentaram diabetes mellitus. A preval\u00eancia da falha terap\u00eautica foi 14% (67), ocorrendo em um tempo mediano de 174 (\u00b141) dias ap\u00f3s a cirurgia card\u00edaca \u00edndice. As causas mais comuns foram cocos gram-positivos e Klebsiella pneumoniae. Nenhum dos achados laboratoriais ou tomogr\u00e1ficos tor\u00e1cicos apresentados durante a ISC esternal \u00edndice esteve relacionado ao desfecho. Ap\u00f3s a an\u00e1lise multivariada, Staphylococcus aureus, Bacilos Gram-Negativos (BGN) resistentes a carbapen\u00eamicos (GNB), fungos, diabetes mellitus e mediastinite \/osteomielite foram preditores positivos de falha terap\u00eautica.  Conclus\u00f5es  BGN resistentes a carbapen\u00eamicos, fungos e S. aureus emergentes foram associados a um maior risco de falha terap\u00eautica na ISC esternal. Al\u00e9m disso, DM e infec\u00e7\u00f5es profundas de les\u00f5es esternais foram fatores contribuintes. Suas implica\u00e7\u00f5es cl\u00ednicas e o papel exato dos microrganismos multirresistentes requerem mais estudos.<\/jats:p>","DOI":"10.36660\/abc.20240464","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T11:57:23Z","timestamp":1748347043000},"source":"Crossref","is-referenced-by-count":1,"title":["Preditores Cl\u00ednicos e Microbiol\u00f3gicos de Falha Terap\u00eautica em Infec\u00e7\u00f5es do S\u00edtio Cir\u00fargico Esternal \u2013 Um Estudo Retrospectivo do Tipo Coorte"],"prefix":"10.36660","volume":"122","author":[{"given":"Jaqueline Fabiano","family":"Palazzo","sequence":"first","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brasil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego Augusto Medeiros","family":"Santos","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  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