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Pseudomonas sternotomy wound infection and sternal osteomyelitis. Complications after open heart surgery

H G Stiver, J Clark, J Kennedy

    JAMA
    |March 9, 1979
    PubMed

    Insights

    Pseudomonas aeruginosa sternotomy wound infections were linked to contaminated chest tube suction pumps after open heart surgery. This highlights a potential source of infection in cardiac surgery patients.

    Area of Science:

    • Infectious Diseases
    • Surgical Site Infections
    • Medical Microbiology

    Background:

    • Sternotomy wound infections pose a significant risk following open heart surgery.
    • Pseudomonas aeruginosa is a common opportunistic pathogen in healthcare settings.

    Purpose of the Study:

    • To investigate the source of Pseudomonas aeruginosa sternotomy wound infections in cardiac surgery patients.
    • To determine the potential role of mediastinal chest tube drainage systems in transmitting infection.

    Main Methods:

    • Retrospective analysis of five cases of Pseudomonas aeruginosa sternotomy wound infections.
    • Isolation and culture of bacteria from wound sites and chest tube drainage systems.
    • Pseudomonas typing and antibiogram analysis of isolates.

    Main Results:

    • All five patients developed sternotomy wound infections, with two experiencing soft-tissue infection and three developing sternal osteomyelitis.
    • A correlation was found between wound isolates and Pseudomonas strains from chest-tube suction pumps.
    • A higher prevalence of matching antibiograms was observed in Pseudomonas isolates from the cardiac surgery ward compared to other wards.

    Conclusions:

    • Mediastinal chest tube drainage systems, specifically suction pumps, may serve as a reservoir for Pseudomonas aeruginosa.
    • Contaminated drainage systems represent a potential source of sternotomy wound infections in cardiac surgery.
    • Implementing enhanced infection control measures for drainage systems is crucial in preventing surgical site infections.

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