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A Rare Case of Post-sternotomy Mediastinitis Caused by Methicillin-Resistant Staphylococcus pseudintermedius, a

Soichiro Ota1, Yuki Hayashi1, Atsushi Harada1

  • 1Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, JPN.

Cureus
|July 24, 2025
PubMed

Insights

A rare case of post-sternotomy mediastinitis (PSM) caused by methicillin-resistant Staphylococcus pseudintermedius (MRSP) in a cardiac surgery patient highlights zoonotic infection risks. Prompt treatment with antibiotics and vacuum-assisted closure (VAC) therapy led to successful recovery.

Area of Science:

  • Infectious Diseases
  • Surgical Site Infections
  • Microbiology

Background:

  • Post-sternotomy mediastinitis (PSM) is a severe complication of cardiac surgery.
  • Effective management involves antibiotics, surgical intervention, and wound care.
  • Vacuum-assisted closure (VAC) therapy is a recognized treatment for infection control and wound healing.

Observation:

  • A 75-year-old male developed PSM 11 days post-ascending aortic replacement.
  • Infection was caused by methicillin-resistant Staphylococcus pseudintermedius (MRSP), a pathogen typically found in animals.
  • The patient had no direct contact with pets during hospitalization, suggesting preoperative colonization.

Findings:

  • The patient was treated with debridement, intravenous antibiotics, and VAC therapy.
  • Successful infection control and wound healing were achieved without the need for flap reconstruction.
  • The patient was discharged without complications.

Implications:

  • This case underscores the rare but significant risk of zoonotic pathogens, like MRSP, causing surgical site infections.
  • Preoperative assessment should include pet ownership history to inform infection control strategies.
  • Awareness of unusual pathogens is crucial for managing complex surgical site infections.
Keywords:
ascending aortic replacementcardiac surgery complicationscoagulase-positive staphylococcimethicillin-resistant staphylococcus pseudintermediusmultidrug-resistant organismspet ownership and infection riskpoststernotomy mediastinitissurgical site infectionvacuum-assisted closure therapyzoonotic infection

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