Médiastinites après chirurgie cardiaque : incidence, microbiologie et facteurs de risque

Mediastinitis after cardiac surgery are feared complications. They follow a preoperative contamination of mediastinal tissues. The prognosis depends on the diagnosis rapidity and early antibiotic therapy. Antimicrobial therapy must be focused on Staphylococcus which is the most commonly isolated pathogen. Mediastinitis represents a major public health problem with significant morbidity and mortality, and is also associated with prolonged hospitalization and important cost of care. Risk factors associated with mediastinitis include factors linked to the patient (obesity, diabetes, respiratory trouble), to the surgery (type and duration of cardiac operative procedures, re-operation for cardiac tamponade or pericardial effusion or re-operation for bleeding) and to the hospital stay (preoperative length of stay and preparation of the patient).