title: Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery.
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).
authors.affiliation: Department of Clinical Microbiology, Dijkzigt University Hospital, Rotterdam, Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Kluytmans
authors.forename: J W
authors.initials: JW
authors.lastname: Mouton
authors.forename: E P
authors.initials: EP
authors.lastname: Ijzerman
authors.forename: C M
authors.initials: CM
authors.lastname: Vandenbroucke-Grauls
authors.forename: A W
authors.initials: AW
authors.lastname: Maat
authors.forename: J H
authors.initials: JH
authors.lastname: Wagenvoort
authors.forename: H A
authors.initials: HA
authors.lastname: Verbrugh
mesh_terms: D001434:Bacteriophage Typing; D006348:Cardiac Surgical Procedures / Q000401:mortality; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009666:Nose / Q000382:microbiology*; D016017:Odds Ratio; D012307:Risk Factors; D013211:Staphylococcus aureus / Q000145:classification / Q000302:isolation & purification*; D013530:Surgical Wound Infection / Q000209:etiology*