Staphylococcus aureus Infections After Elective Cardiothoracic Surgery: Observations From an International Randomized Placebo-Controlled Trial of an Investigational S aureus Vaccine

Open Forum Infectious Diseases
Keith B AllenAjoke Sobanjo-ter Meulen

Abstract

An unmet need to prevent Staphylococcus aureus (SA) infections after cardiothoracic surgery persists despite current practices. Cost-effective implementation of preventive strategies requires contemporary knowledge about modifiable risk factors. From 2007 to 2011, an international, double-blind, randomized placebo-controlled trial of a novel SA vaccine (V710) was conducted in 7664 adults scheduled for median sternotomy at 164 sites. We analyzed SA infections developing up to 360 days postoperatively in 3832 placebo recipients. Coronary artery bypass grafting was performed in 80.8% (3096 of 3832) of placebo recipients. The overall incidence of any postoperative SA infection was 3.1% (120 of 3832). Invasive SA infections (including bacteremia and deep sternal-wound infections) developed in 1.0%. Methicillin-resistant SA (MRSA) accounted for 19% (23 of 120) of SA infections, with 57% (13 of 23) of the MRSA infections occurring in diabetic patients. All-cause mortality was 4.1% (153 of 3712) in patients without SA infection, 7.2% (7 of 97) in methicillin-susceptible SA (MSSA) infections, and 17.3% (4 of 23) in MRSA infections (P < .01). Staphylococcus aureus nasal carriage was detected preoperatively in 18.3% (701 of 3096) patients...Continue Reading

References

Jul 26, 2005·The Annals of Thoracic Surgery·Seth Daniel ForceJoseph I Miller
Feb 10, 2009·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Zeina A KanafaniVance G Fowler
Aug 20, 2009·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·E S YangL G Miller
Jan 8, 2010·The New England Journal of Medicine·Lonneke G M BodeMargreet C Vos
Jun 4, 2010·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Deverick J AndersonVance G Fowler
Feb 8, 2013·The New England Journal of Medicine·Michael W ClimoEdward S Wong
Mar 7, 2013·Clinical Orthopaedics and Related Research·Antonia F ChenNalini Rao
Apr 4, 2013·JAMA : the Journal of the American Medical Association·Vance G FowlerAjoke Sobanjo-ter Meulen
May 31, 2013·The New England Journal of Medicine·Susan S HuangUNKNOWN AHRQ DECIDE Network and Healthcare-Associated Infections Program
May 31, 2013·The New England Journal of Medicine·Michael B Edmond, Richard P Wenzel
Aug 27, 2013·American Journal of Infection Control·Lalit KalraKathleen G Julian
Oct 25, 2013·Journal of Clinical Microbiology·Rupak DattaLauri Thrupp
Jan 21, 2014·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Anucha Apisarnthanarak, Linda M Mundy

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Citations

May 31, 2016·Perioperative Medicine·Sarka MoravcovaColin Hamilton-Davies
Feb 21, 2019·Expert Opinion on Pharmacotherapy·Daniele Roberto GiacobbeClaudio Viscoli
Feb 6, 2020·Infection and Immunity·David N HernandezGregg J Silverman
Oct 5, 2019·The Journal of Infection·Helen S MarshallAnnaliesa S Anderson
Feb 17, 2019·Environmental Research·John Kerr WhiteAnne Mette Madsen

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Methods Mentioned

BETA
coronary
coronary artery bypass
PCR

Clinical Trials Mentioned

NCT00518687

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