Serious infectious complications of open-heart surgery

Serious infectious complications of open-heart surgery in 521 adults who underwent 534 open-heart procedures are reviewed. Bacteremia complicated seven (1.3%) of the procedures, carditis six (1.1%) and deep sternal wound infections nine (1.7%). The overall rate of these infections was 4.1% with an associated death rate of 11.7% (2 of 17). With respect to the risk of this complication, no differences were noted in the age of the patients, duration of surgery or perioperative prophylaxis with cephalothin or cloxacillin. The chance of carditis developing was significantly related (p less than 0.001) to a valve replacement procedure and the risk of a deep sternal wound infection (p less than 0.01) to a procedure classed as "other". Staphylococci remained the most commonly isolated pathogens with an almost equal frequency of Staphylococcus epidermidis and Staphylococcus aureus. Gram-negative aerobes and Streptococcus faecalis were found to be other important pathogens in this clinical setting.