title: Epidemiology and prevention of surgical site infections after cardiac surgery.
abstract: Deep sternal wound infection is the major infectious complication in patients undergoing cardiac surgery, associated with a high morbidity and mortality rate, and a longer hospital stay. The most common causative pathogen involved is Staphylococcus spp. The management of post sternotomy mediastinitis associates surgical revision and antimicrobial therapy with bactericidal activity in blood, soft tissues, and the sternum. The pre-, per-, and postoperative prevention strategies associate controlling the patient's risk factors (diabetes, obesity, respiratory insufficiency), preparing the patient's skin (body hair, preoperative showering, operating site antiseptic treatment), antimicrobial prophylaxis, environmental control of the operating room and medical devices, indications and adequacy of surgical techniques. Recently published scientific data prove the significant impact of decolonization in patients carrying nasal Staphylococcus aureus, on surgical site infection rate, after cardiac surgery.
authors.affiliation: Service de bactériologie et d'hygiène hospitalière, unité de gestion du risque infectieux, CHU de Nantes, bâtiment Le Tourville, 5, rue du Pr-Yves-Boquien, 44093 Nantes cedex 01, France; UFR médecine, université de Nantes, EA 3826, Nantes, France. Electronic address: didier.lepelletier@chu-nantes.fr.
authors.forename: D
authors.initials: D
authors.lastname: Lepelletier
authors.forename: C
authors.initials: C
authors.lastname: Bourigault
authors.forename: J C
authors.initials: JC
authors.lastname: Roussel
authors.forename: C
authors.initials: C
authors.lastname: Lasserre
authors.forename: B
authors.initials: B
authors.lastname: Leclère
authors.forename: S
authors.initials: S
authors.lastname: Corvec
authors.forename: S
authors.initials: S
authors.lastname: Pattier
authors.forename: T
authors.initials: T
authors.lastname: Lepoivre
authors.forename: O
authors.initials: O
authors.lastname: Baron
authors.forename: P
authors.initials: P
authors.lastname: Despins
mesh_terms: D019072:Antibiotic Prophylaxis; D006348:Cardiac Surgical Procedures; D002353:Carrier State; D004866:Equipment Contamination / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D008480:Mediastinitis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D009296:Nasal Cavity / Q000382:microbiology; D009765:Obesity / Q000453:epidemiology; D010000:Osteitis / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D011300:Preoperative Care; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control; D056346:Sternotomy; D013249:Sternum / Q000382:microbiology; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*
keywords: Cardiac surgery; Chirurgie cardiaque; Facteurs de risque; Infection du site opératoire; Prevention; Prévention; Risk factors; Surgical site infection