Faculty Collaboration Database

Coagulase-negative staphylococcal infections in vascular surgery: epidemiology and pathogenesis. Infect Control Hosp Epidemiol 1989 Mar;10(3):111-7

Date

03/01/1989

Pubmed ID

2651513

DOI

10.1086/645977

Scopus ID

2-s2.0-0024633936 (requires institutional sign-in at Scopus site)   25 Citations

Abstract

Staphylococcal infection of a vascular prosthesis is a relatively uncommon complication of peripheral vascular surgery; however, these infections and their sequelae can be catastrophic. The majority of prosthetic graft infections are caused by mucin-producing strains of Staphylococcus epidermidis, which express varying degrees of adherence to the synthetic substrates. Studies have demonstrated that the components and construction characteristics of the graft, implantation site, administration of antimicrobial agents, and endogenous microbial flora are all identifiable risk factors in vascular graft infections. Mucin production, a known virulence factor, has recently been shown to occur in endogenous coagulase-negative staphylococci (CNS) at the time of hospital admission. While mucin production plays an important role in the persistence of graft infections, there is no evidence that suggests a relationship between mucin and antimicrobial resistance. Identifying characteristics of (CNS) graft infections may include a draining wound sinus, poor graft incorporation, a perigraft exudate or a pseudoaneurysm at the anastomotic site. The occult nature of these infections, in which the patient is often asymptomatic, makes diagnosis and treatment difficult. The graft or graft exudate may be negative when routine culture methods are employed. The recognition of CNS graft infections requires a high index of suspicion and the treatment of these infections requires understanding of the pathogenic process, individualized surgical management, and the judicious use of antimicrobial agents.

Author List

Edmiston CE Jr, Schmitt DD, Seabrook GR

MESH terms used to index this publication - Major topics in bold

Blood Vessel Prosthesis
Coagulase
Cross Infection
Cross-Sectional Studies
Humans
Microscopy, Electron, Scanning
Staphylococcal Infections
Staphylococcus epidermidis
Surface Properties
Surgical Wound Infection