The Role of Nasal Carriage of the Staphylococcus Aureus in Deep Sternal Wound Infection After Cardiac Surgery

Bülent TÜNERİR, Yavuz BEŞOĞUL, Turan YAVUZ, Sadettin DERNEK, Behçet SEVİN, Tuğrul KURAL, Recep ASLAN

Osmangazi Üniversitesi Tıp Fakültesi, Göğüs Kalp ve Damar Cerrahisi Anabilim Dalı, Eskişehir

Deep sternal infection occured after the cardiac surgery associates with osteomyelitis, sternal dehiscence and mediastinitis, so that it is most important cause of the high morbidity and mortality. This study was to evaluate the relationship of nasal carriage of the staphylococcus aureus as a risk factor for the development of wound infection at the sternotomy site after cardiac surgery. 179 patients undergoing cardiac surgery were included in the study. There were 22 (%12.2) nasal carriage and 8 (%4.4) deep sternal infection caused by meticilline resistance staphylococcus aureus (MRSA). In 7 of 8 patients (%87.5) with sternal infection, the nasal carriage of the stafilococcus aureus were demonstrated. All infected patients were treated with 2 g of vancomisine daily. 5 patients were salvaged but 3 patients died. Mean hospitaly stay time was 21 ± 4 days in infected patients and was 7 ± 2 days non-infected patients.

In conclusion, we show that the nasal carriage of the staphylococcus aureus is an important risk factor for the development of wound infection at the sternum after cardiac surgery. Therefore, we belive that in patients undergoing open heart surgery, preoperative detection of the nasal carriage of the staphylococcus aureus improves operative success and reduces the hospital mortality and costs.

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