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Ann Thorac Surg 1990;49:454-457
© 1990 The Society of Thoracic Surgeons

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Articles

Bacteremia and sternal infection after coronary artery bypass grafting

State University of New York Health Science Center, Syracuse, New York USA

Accepted for publication November 20, 1989.

^_* Address reprint requests to Dr Kohman, Department of Surgery, 750 E Adams St, Syracuse, NY 13210.

Sternal wound infection remains a source of substantial morbidity and mortality after coronary artery bypass grafting. We noted an association between bacteremias and sternal wound complications in these patients. A review of 835 consecutive coronary bypass patients showed a 3.2% incidence of bacteremia and a 1.9% incidence of deep and superficial sternal wound infection. The sternal wound was the most common source of bacteremia, accounting for 59% of the infections. Coagulasc-negative Staphylococcus was responsible for one half of the sternal wound infections. Often, a positive blood culture was the first manifestation of wound infection, occurring before local signs were manifest. We recommend multiple blood cultures in postoperative coronary bypass patients with pronounced fever. If no source of infection can be identified, sternal wound aspirate may be revealing. Appropriate early wound management can then be carried out, maximizing chances for good recovery.

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