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An outbreak of coagulase-negative staphylococcal surgical-site infections following aortic valve replacement

R L Lark1, K VanderHyde, G M Deeb

  • 1Department of Internal Medicine, University of Michigan Health System, Ann Arbor 48109-0378, USA.

Infection Control and Hospital Epidemiology
|January 5, 2002
PubMed
Abstract

Insights

A surgical resident was linked to a coagulase-negative staphylococcal outbreak following bioprosthesis implantation. The outbreak was multifactorial, but vancomycin prophylaxis and surgical technique changes resolved it.

Area of Science:

  • Infectious Diseases
  • Surgical Site Infections
  • Epidemiology

Background:

  • Coagulase-negative staphylococcal infections pose a significant risk following cardiac bioprosthesis implantation.
  • Identifying the source and risk factors for such outbreaks is crucial for patient safety and effective intervention.

Purpose of the Study:

  • To investigate the cause of a coagulase-negative staphylococcal outbreak after Medtronic Freestyle bioprosthesis implantation.
  • To identify specific risk factors contributing to surgical-site infections in this patient population.

Main Methods:

  • A retrospective case-control study was conducted at a university referral center.
  • The study analyzed a cohort of 64 patients who underwent Freestyle valve replacement.
  • Statistical analysis compared cases with infections to controls without infections.

Main Results:

  • Seven patients developed infections (10.9%), including mediastinitis and endocarditis.
  • No significant differences were found in patient demographics or standard perioperative factors.
  • A surgical resident was significantly associated with infection (OR, 7.68), and epidemic strains were linked to cases involving this resident.

Conclusions:

  • A surgical resident was identified as a significant factor in the outbreak.
  • The outbreak was likely multifactorial, involving the identified resident and potentially other unisolated sources.
  • Implementing vancomycin prophylaxis and modifying surgical techniques led to the resolution of the outbreak.

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