Predominant Pathogens in Sternal Wound Infections Following Cardiac Surgery: A Systematic Review
Abstract
Introduction: A surgical incision infection known as sternal wound infection (SWI) usually occurs in one month after cardiac surgery. Many different pathogens can cause SWI. Additional risk factors that contribute to the formation of these infections include obesity, chronic obstructive pulmonary disease (COPD), and the long-term use of ventilation devices, poor nutrition, diabetes mellitus, re-exploration of bleeding event, age, duration of the surgery, duration of hospital stay, type of surgery, and postoperative blood transfusion. The mortality rates of sternal wound infections following heart surgery can vary from 10% to 47% which presents a serious and potentially fatal consequence. This review aims to recognize the microbes involved in infection in order to properly manage SWI patients and reduce mortality and morbidity associated with post-cardiac surgery SWI.
Methods: A systematic review was conducted according to PRISMA criteria, with a literature search across multiple databases such as PubMed, Science Direct, and Google Scholar until September 6th, 2024. Eligibility criteria included retrospective case-control studies or randomized controlled trials (RCTs) in English on adults diagnosed with SWI after open heart surgery, as well as studies that studying microbes causing SWI and presenting raw data. Data from studies that met the criteria were evaluated to assess the microbes involved in post-cardiac surgery sternal wound infection.
Results: A total of 10,596 references were discovered and 8 articles were chosen for the integrative review based on duplication, relevance and inclusion/exclusion criteria.
Conclusion: The most common microbes found in cases of sternal wound infection after cardiac surgery were coagulase negative Staphylococcus (CoNS) followed by Staphylococcus epidermidis, which is the normal flora of human skin. In addition, the presence of obesity, diabetes, and critical preoperative status were associated with an increased risk of SWI, explaining that there is a complex interaction between patient factors and microbial involvement.
Keywords: sternal wound infection, cardiac surgery, microbe
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References
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