Analysis of Risk Factors and Effect of Vancomycin for Sternal Infection after Coronary Artery Bypass Graft.
- Author:
Jong Hyun BAEK
1
;
Tae Eun JUNG
;
Dong Hyup LEE
;
Jang Hoon LEE
;
Jung Hee KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, College of Medicine, Yeungnam University, Korea. tejung@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Wound infection;
Sternum;
Coronary artery bypass
- MeSH:
Candida albicans;
Coronary Artery Bypass;
Coronary Vessels;
Curettage;
Diabetes Mellitus;
Humans;
Incidence;
Methicillin Resistance;
Methicillin-Resistant Staphylococcus aureus;
Pseudomonas aeruginosa;
Reoperation;
Retrospective Studies;
Risk Factors;
Smoke;
Smoking;
Staphylococcus aureus;
Staphylococcus epidermidis;
Sternum;
Thoracic Surgery;
Vancomycin;
Wound Infection
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2010;43(4):381-386
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Sternal wound infection (SWI) is an important complication after cardiac surgery. The aim of this study was to investigate the predictors affecting sternal wound infection and preventive factors including short term Vancomycin therapy in patients who underwent coronary artery bypass grafting (CABG). MATERIAL AND METHOD: A retrospective study was done using data collected from January 2001 through December 2007. This included 219 patients who had isolated CABG. The definition of SWI was documentation from a microbiological study and a requirement for simple closure or other surgical revision. RESULT: The overall incidence of SWI was 7.8% (n=17). The causative organisms were methicillin resistant Staphylococcus aureus (MRSA, n=13), methicillin resistant Staphylococcus epidermidis (n=2), Pseudomonas aeruginosa (n=1), and Candida albicans (n=1). Ten cases had deep sternal wound infection with mediastinitis; 7 cases had a superficial wound infection. Infection-related mortality was low (1/17; 6%). Diabetes mellitus (p=0.006) and smoking history (p=0.020) were factors that predicted high risk. Short term use of vancomycin decreased the incidence of MRSA-associated SWI (p=0.009). For treatment, curettage and rewiring or flap were needed in most cases (88%, n=14). CONCLUSION: Patients who had diabetes mellitus and a smoking history need careful management. Short term use of vancomycin is effective for prevention of SWI with MRSA.
