SCHMITT DV, CLAROS MC, GUMMERT JF, RODLOFF AC, MOHR FW; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).

Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. K-1454.

Department of Cardiac Surgery, University of Leipzig, Leipzig, Germany

BACKGROUND:Mediastinitis after cardiac surgery is a rare but life-threatening complication with a reported mortality of 14-40%. It is associated with prolonged hospital stay and increased cost. This study describes risk factors, incidence, microbiological results and economical aspects. METHODS: In a consecutive, retrospective study 10373 patients undergoing cardiac surgery have been enrolled from January 1998 to December 2000. Risk and economic factors have been analysed. Therapy was based on microbiological analysis, surgical debridement accompanied with an irrigation/suction system and systemic antibiotic therapy based on cephalosporins, glycopeptides or streptogramines (quinopristin/dalfopristin). RESULTS: Incidence of mediastinitis was 1.3% (134/10373 patients). Risk factor analysis revealed four additional factors: diabetes, chronic obstructive pulmonary disease, reintubation, duration of surgery >4h. The overall hospital mortality rate in the mediastinitis population was 23.1% (31/134 patients). The spectrum of pathogenic organisms isolated from mediastinal fluid was: Staphylococcus aureus (57%), methicillin resistant S. aureus (MRSA) (6%), coagulase negative staphylococci (CNS)(17%), gramnegative organisms (18%), other (2%). Economical analysis revealed additional costs of DM 75000 (about 35000 USD). CONCLUSIONS:1. Mediastinal infection is a severe complication with an incidence of 1.3% after cardiac surgery. 2. Staphylococcus species represent 80% of all isolated pathogens. 3. Prolonged hospital stay of 24.4 days increases costs dramatically. 4. New classes of antibiotic agents known as streptogramines and oxazolidinones are very effective instruments against MRSA and CNS.

Publication Types:

• Meeting Abstracts

Keywords:

• Anti-Bacterial Agents
• Cardiac Surgical Procedures
• Communicable Diseases
• Debridement
• Humans
• Incidence
• Mediastinitis
• Retrospective Studies
• Risk Factors
• Staphylococcal Infections
• Staphylococcus aureus
• Sternum
• Surgical Wound Infection
• Thoracic Surgery
• Wound Infection
• epidemiology
• injuries
• surgery
• therapy

Other ID:

• GWAIDS0030210

UI: 102269842

From Meeting Abstracts