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Care bundle to prevent methicillin-resistant Staphylococcus aureus sternal wound infection after off-pump coronary artery bypass

  • Chen-Yen Chien
    Affiliations
    Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

    Department of Surgery, Makay Memorial Hospital, Mackay Medicine, Nursing and Management College, Taipei, Taiwan
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  • Cheng-Hsin Lin
    Affiliations
    Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

    Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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  • Ron-Bin Hsu
    Correspondence
    Address correspondence to Ron-Bin Hsu, MD, National Taiwan University Hospital, No. 7, Chung-Shan S. Road, Taipei, Taiwan 100, R.O.C.
    Affiliations
    Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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      Methicillin-resistant Staphylococcus aureus (MRSA) sternal wound infection (SWI) after cardiac surgery is endemic in our hospital. An infection control care bundle with preoperative chlorhexidine showering and povidone iodine paint before bathing was introduced in 2006. From 2001 to 2012, 23 (2.3%) of 1,010 patients undergoing off-pump coronary artery bypass had SWIs. SWI significantly decreased after 2006 (1.4% vs 3.4%, respectively; P = .03). Care bundle was more protective against MRSA infection (2.3% vs 0.5%, respectively; P = .021). SWI remained a common complication after off-pump coronary artery bypass. MRSA infection was most common, and the mortality was high. Care bundle can effectively decrease the incidence of SWI, especially infection caused by MRSA.

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