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Care bundle to prevent methicillin-resistant Staphylococcus aureus sternal wound infection after off-pump coronary

Chen-Yen Chien1, Cheng-Hsin Lin2, Ron-Bin Hsu3

  • 1Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Surgery, Makay Memorial Hospital, Mackay Medicine, Nursing and Management College, Taipei, Taiwan.

American Journal of Infection Control
|April 30, 2014
PubMed

Insights

A new infection control bundle significantly reduced sternal wound infections (SWI) in cardiac surgery patients, particularly those caused by Methicillin-resistant Staphylococcus aureus (MRSA). This intervention improved patient outcomes and decreased infection rates.

Area of Science:

  • Infectious Disease
  • Surgical Site Infections
  • Public Health

Background:

  • Sternal wound infection (SWI) caused by Methicillin-resistant Staphylococcus aureus (MRSA) is a significant complication following cardiac surgery.
  • MRSA SWI presents a high mortality risk and poses an endemic challenge in healthcare settings.

Purpose of the Study:

  • To evaluate the effectiveness of an infection control care bundle in reducing the incidence of SWI after cardiac surgery.
  • To assess the impact of the care bundle specifically on MRSA infections.

Main Methods:

  • Implementation of a care bundle including preoperative chlorhexidine showering and povidone-iodine application before bathing starting in 2006.
  • Retrospective analysis of SWI rates in patients undergoing off-pump coronary artery bypass surgery from 2001 to 2012.

Main Results:

  • A significant decrease in SWI incidence was observed after the care bundle's introduction (1.4% vs. 3.4%, P = .03).
  • The care bundle demonstrated greater protection against MRSA infections (0.5% vs. 2.3%, P = .021).
  • Despite the decrease, SWI remains a notable complication, with MRSA being the most common pathogen and associated with high mortality.

Conclusions:

  • The implemented infection control care bundle effectively reduces the incidence of SWI after cardiac surgery.
  • The care bundle is particularly effective in preventing MRSA sternal wound infections, thereby improving patient safety and outcomes.
Keywords:
Care bundleMethicillin resistanceOff pump coronary artery bypassStaphylococcus aureusSternal wound infection

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