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Related Experiment Videos

Staphylococcal post-sternotomy mediastinitis: five year audit.

Arlo Upton1, Sally A Roberts, Paget Milsom

  • 1Department of Clinical Microbiology, Auckland District Health Board, New Zealand. aupton@fhcrc.org

ANZ Journal of Surgery
|April 21, 2005
PubMed
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Staphylococcal mediastinitis affects 1.2% of patients after sternotomy, with diabetes and ethnicity as key risk factors. This serious infection has high mortality and relapse rates, necessitating optimized prevention and management strategies.

Area of Science:

  • Medical research
  • Infectious disease epidemiology
  • Surgical outcomes

Background:

  • Post-sternotomy mediastinitis (PSM) occurs in 0.8-2.3% of cases, frequently caused by staphylococci.
  • Obesity and diabetes are established risk factors for PSM.
  • Staphylococcal PSM presents significant morbidity and mortality.

Purpose of the Study:

  • To determine the incidence of staphylococcal PSM.
  • To identify risk factors for staphylococcal PSM.
  • To audit the management of staphylococcal PSM.

Main Methods:

  • Retrospective review of clinical records for staphylococcal PSM cases (1998-2003).
  • Data collection included demographics, comorbidities, operation type, microbiology, management, and outcomes.

Related Experiment Videos

  • Comparison with a prospective cardiac surgery database.

    • Main Results:

    • Incidence of staphylococcal PSM was 1.2% (60/5176 sternotomies).
    • Staphylococcus aureus (82%) and coagulase-negative staphylococci (18%) were identified; 16% of S. aureus were methicillin-resistant.
    • Risk factors included ethnicity, diabetes, emergency surgery, ejection fraction, and preoperative stay length. In-hospital mortality was 15%; 18% had treatment failure.

    Conclusions:

    • Staphylococcal mediastinitis is a severe complication with substantial mortality and relapse rates.
    • The study highlights the need for optimized prevention and management of surgical site infections.
    • Clinical pathways require evaluation to improve outcomes for staphylococcal PSM.