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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA

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Factors associated with methicillin-resistant coagulase-negative staphylococci as causing organisms in deep sternal

R Sommerstein1, P Kohler1, M J Wilhelm2

  • 1Division of Infectious Diseases and Hospital Epidemiology, Switzerland.

New Microbes and New Infections
|June 5, 2015
PubMed

Insights

Preoperative antibiotics fail against methicillin-resistant coagulase-negative staphylococci (CoNS) in cardiac surgery. Early reintervention for noninfectious causes predicts these deep sternal wound infections, guiding improved prophylaxis strategies.

Area of Science:

  • Infectious Diseases
  • Surgical Infections
  • Antimicrobial Resistance

Background:

  • Established antibiotic prophylaxis is insufficient for preventing methicillin-resistant coagulase-negative staphylococci (CoNS) infections post-cardiac surgery.
  • Deep sternal wound infections (DSWI) pose a significant risk in cardiac surgery patients.

Purpose of the Study:

  • To identify predictors of deep sternal wound infections specifically caused by methicillin-resistant CoNS.
  • To inform the development of more effective preoperative antimicrobial prophylaxis protocols.

Main Methods:

  • A case-control study involving cardiac surgery patients undergoing sternotomy between June 2009 and March 2013.
  • Prospective data collection from a Swiss tertiary care center.
  • Analysis of factors associated with methicillin-resistant CoNS DSWI.

Main Results:

  • Out of 1999 patients, 82 developed DSWI; 36 were caused by CoNS, with 25 being methicillin-resistant.
  • Early reintervention for noninfectious causes was a significant predictor (OR 4.3) of methicillin-resistant CoNS DSWI.
  • Perioperative antimicrobial therapy, early noninfectious reintervention, and delayed diagnosis (>21 days) were associated with methicillin resistance in CoNS DSWI.

Conclusions:

  • Early reintervention for noninfectious causes is a key risk factor for methicillin-resistant CoNS DSWI.
  • Findings highlight the inadequacy of current prophylaxis and suggest areas for improvement.
  • Tailoring preoperative antimicrobial prophylaxis is crucial for combating resistant CoNS infections.
Keywords:
Cardiac surgerycoagulase-negative staphylococcimethicillin resistancesternotomysurgical site infection

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