Deep sternal wound infection following cardiac surgery Epidemiology and causative germs

  Introduction: Deep sternal wound infection is a rare but serious complication after cardiac surgery that can increase mortality and morbidity. The aim of this study was to investigate the incidence and causative germs of deep sternal wound infection following cardiac surgery.   Methods: Data were collected retrospectively from patients who underwent different cardiac surgeries including coronary artery bypass grafting and valvular heart surgeries between July 2010 and October 2012 at a teaching hospital in the north east of Iran. Patients with a deep sternal wound infection (DSWI) were defined based on clinical findings and culture results of the wound. The patients were tracked for the development of DSWI and causative germs and sensitivity were identified according to the microbiological studies.   Results: 4621 patients underwent different cardiac surgeries during the study period. There were 82 cases (1.77%) of DSWI with mean age of 53.93 years and male to female ratio of 47:35 with mortality rate of 10.9%. The most common germs in order of decreasing frequency included Klebsiella, Pseudomonas, Staphylococus Coagulase Negative, Acinetobacter, Staphylocciaureus, Escherichia coli, methicillin resistant Staphylocciaureus, Providenciarettgeri, and Obligatory anaerobe Streptococus.   Conclusions: We conclude that DSWI remains a rare but devastating complication and is associated with significant comorbidity, increased hospital mortality, and reduced long-term survival with gram negative rods as the most common pathogens.