Nasal Carriage Of Staphylococcus aureus As A Major Risk Factor For Wound Infections After Cardiac Surgery

TLDR

The study aimed to determine whether preoperative nasal carriage of Staphylococcus aureus increases the risk of sternal wound infection after cardiac surgery. A case‑control analysis of 1,980 consecutive cardiac surgery patients identified 40 infected cases and 120 matched controls. Nasal carriage, insulin‑dependent diabetes, and younger age were significant risk factors, with carriage conferring a 9.6‑fold higher odds of infection, a 30‑day longer hospital stay, and a mortality rate of 10% versus 0.8% in controls.

Abstract

To evaluate the importance of nasal carriage of Staphylococcus aureus as a risk factor for the development of wound infection at the sternotomy site after cardiac surgery, a case-control study was done. The study population consisted of 1980 consecutive patients. Cases were all patients who developed a sternal wound infection from which S. aureus was cultured. Forty cases were identified, and 120 controls were selected. Preoperative nasal carriage of S. aureus, insulin-dependent diabetes mellitus, and younger age were identified as significant risk factors. The crude odds ratio of nasal carriage was 9.6 (95% confidence interval, 3.9-23.7). The median postoperative length of hospital stay for cases was 30 days longer than for controls. Mortality was also significantly higher for cases than for controls (10.0% and 0.8%, respectively).