Year 2020 Vol. 28 No 1




Perm State Medical University named after Academician E. A. Wagner, Perm,
The Russian Federation

Objective. To determine the possibility of the sternal wound infection with S. aureus coprocultures in patients after cardiac surgery.
Methods. The main biological properties, antibiotic sensitivity and genomic variants of 26 S. aureus isolated from the discharge of the sternal wound and colon of 13 patients with sterno-mediastinitis, sternum and ribs osteomyelitis after cardiac surgery were studied. The virulence factors, persistence and antibiotic sensitivity were determined by standard methods, genotyping was performed by RAPD-PCR.
Results. The comparative analysis of phenotypic characteristics revealed in six pairs of S. aureus isolated from the sternal wounds and colon from the specific patients of 13 examined, a definite biological profile: the presence or absence of the same virulence enzymes: hemolysins, DNAasa, lecithinase; persistence factors: anti-lysozyme, anti-complement and anti-lactoferrin activity, as well as ability of biofilm formation. The same pairs of strains were identical in sensitivity to antimicrobial drugs. The analysis of antibiogram of all 12 S. aureus isolates (6 pairs) allowed them to be classified as strains community-acquired origin. Genotyping confirmed the relationship of pairs of S. aureus, isolated from discharge of sternal wounds and feces, in six patients.
Conclusions. Intestinal dysbiosis with the pronounced biotope colonization by S. aureus along with the negative factors of long hours of operations with the artificial blood circulation, cause a decrease in colonization resistance, impaired barrier function of the intestinal mucosa. Against this background, hematogenous translocation of S. aureus from the intestinal mucosa and endogenous infection of the surgical area are possible. In the process of the preoperative preparation of patients, it is advisable to perform bacteriological examination of feces for intestinal dysbiosis and, if necessary, to carry out a correction of biotope microbiome.

Keywords: cardiac surgery, sterno-mediastinitis, S. aureus, endogenous infection
p. 16-23 of the original issue
  1. Bokeriia LA, Beloborodova NV. Infektsiia v kardiokhirurgii. Moscow, RF: Izd-vo NTsSSKh im. A. N. Bakuleva RAMN; 2007. 582 p. (In Russ.)
  2. Zorkin AA, Larionov MIu, Tulupov VA. Mediastinit: etiologiia, patogenez, klinika, diagnostika i lechenie. (In Russ.)
  3. Fadeeva TV, Vereschagina SA, Filatova LS, Sadakh MV, Grigoriev EG. Microbiological estimation of postoperative wound infection in multifield surgical clinic.Infektsii v Khirurgii. 2012;10(4):14-20. infections-04-2012/mikrobiologicheskaya_ otsenka_posleoperatsionnoy_ranevoy_infektsii_v_mnogoprofilnoy_khirurgicheskoy_k/ (In Russ.)
  4. Gorbunov VA, Dzhordzhikiya RK, Mukharyamov MN, Vagizov II. Management of post-sternotomy mediastinitis in cardiac patients. Khirurgiia. Zhurn im NI Pirogova. 2016;11(vyp 2):41-45. doi: 10.17116/hirurgia201611241-45 (In Russ.)
  5. Okonta KE, Anbarasu M, Jamesraj J, Kurian VM, Rajan S. Sternal wound infection following open heart surgery: appraisal of incidence, risk factors, changing bacteriologic pattern and treatment outcome. Ind J Thorac Cardiovasc Surg. 2011 Jan;27(10):28-32. doi: 10.1007/s12055-011-0081-9
  6. Bondarenko VM, Matsulevich TV. Disbakterioz kishechnika kak kliniko-laboratornyi sindrom. Moscow, RF: GEOTAR-Media; 2007. 304 p. (In Russ.)
  7. Bukharin OV. Persistence of pathogenic bacteria. Moscow, RF: Meditsina; 1999. 367 p. (In Russ.)
  8. Merritt JH, Kadouri DE, OToole GA. Growing and analyzing static biofilms. Curr Protoc Microbiol. 2005 Jul;Chapter 1:Unit 1B.1. doi: 10.1002/9780471729259.mc01b01s00
  9. Haase A, Smith-Vaughan H, Melder A, Wood Y, Janmaat A, Gilfedder J, Kemp D, Currie B. Subdivision of Burkholderia pseudomallei ribotypes into multiple types by random amplified polymorphic DNA analysis provides new insights into epidemiology. J Clin Microbiol. 1995 Jul;33(7):1687-90.
  10. Huang H, Flynn NM, King JH, Monchaud C, Morita M, Cohen SH. Comparisons of community-associated methicillin-resistant Staphylococcus aureus (MRSA) and hospital-associated MSRA infections in Sacramento, California. J Clin Microbiol. 2006 Jul;44(7):2423-27. doi: 10.1128/JCM.00254-06
  11. Krasnogolovets VN. Disbakterioz kishechnika. Moscow: Meditsina; 1989. 208 p. (In Russ.)
  12. Kasatov AV, Gorovits ES, Timasheva OA, Pospelova SV, Sukhanov SG. Microflora and biological properties of the microorganisms Staphylococcus, discharged from the patients with sternal mediastinitis. Med Alm. 2013;(2):107-10. (In Russ.)
  13. Lemaignen A, Birgand G, Ghodhbane W, Alkhoder S, Lolom I, Belorgey S, Lescure FX, Armand-Lefevre L, Raffoul R, Dilly MP, Nataf P, Lucet JC. Sternal wound infection after cardiac surgery: incidence and risk factors according to clinical presentation. Clin Microbiol Infect. 2015 Jul;21(7):674.e11-8. doi: 10.1016/j.cmi.2015.03.025
  14. Cotogni P, Barbero C, Rinaldi M. Deep sternal wound infection after cardiac surgery: Evidences and controversies. World J Crit Care Med. 2015 Nov 4;4(4):265-73. doi: 10.5492/wjccm.v4.i4.265. eCollection 2015 Nov 4.
Address for correspondence:
614990, Russian Federation,
Perm, Petropavlovskaya Str., 26,
Perm State Medical University
Named after Academician E. A. Wagner,
Department of Microbiology and Virology.
Tel. +7 912 496-30-33,
Eduard S. Gorovitz
Information about the authors:
Kasatov Anatolii V., PhD, Associate Professor, Head of the Hospital Surgery Department, Perm State Medical University named after Academician E. A. Wagner, Perm, Russian Federation.
Gorovitz Eduard S., MD, Professor, Head of the Department of Microbiology and Virology, Perm State Medical University named after Academician E. A. Wagner, Perm, Russian Federation.
Kuznetsova Marina V., MD, Professor of the Department of Microbiology and Virology, Perm State Medical University named after Academician E. A. Wagner, Perm, Russian Federation.
Contacts | ©Vitebsk State Medical University, 2007-2023