Fungal and bacterial co-infection in the superficial and deep sternal wound after open cardiac surgery

Abstract

Background and Objectives: Sternum infection increases the time of the patients stay in the hospital and, as a result, increases the treatment costs. This study aimed to evaluate the fungal and bacterial co-infection in the superficial and deep sternal wounds after open cardiac surgery and its relationship with risk factors, as sternal infection increases the time of the patient's stay in the hospital and, as a result, increases the treatment costs.

Materials and Methods: Data were collected using a questionnaire and sampling with two swabs after open heart surgery and hospitalization from 21 March 2018 to 20 March 2019 and sent to the laboratory for diagnosis of microorganisms effective in wound infection. Susceptibility testing for fluconazole and specific antibiotics was performed by the disk diffusion method.

Results: Out of 210 patients studied, 2% of patients had deep sternal wound infections. The most common coinfection fungal and bacterial agents in sternal wounds were caused by Staphylococcus aureus with Candida glabrata 4% and Escherichia coli with Candida albicans 2%. S. aureus and E. coli showed the highest antibiotic susceptibility to the antibiotics ciproflox- acin, norfloxacin, meropenem, and imipenem. Candida glabrata and Candida albicans had the highest rate of resistance to fluconazole.

Conclusion: According to the results of this study, patients on the 7th day in the cardiac care unit (CCU) and the 28th day are at higher risk of getting confection of fungi with bacteria in the sternal wound. Therefore, timely and appropriate antibiotic therapy, including the use of appropriate antibiotics, can be an important step in the patient's recovery.