[HSF] Post op mediastinitis

[Ani Anyanwu]

We once had a transplant patient who 2 days post transplant grew serratia from all his chest tubes, lines, and blood etc. He was otherwise well at the time. Within a few days he developed culminant and ultimately fatal mediastinitis. That month there were also two other patients with mediastinitis with same organism. The infection was ultimately traced to a bottle of povidone iodine (betadine) used for skin preparation - this bottle was used for additional prep in patients where a small single bottle would not suffice. Culture of this solution grew the same organism. In a bid to reduce infection and introduce asepsis in the transplant patients we prepped the patients twice hence the need for the additional solution but in doing a second prep, we were actually coating our patient with serratia. After that we stopped using communal bottles of antiseptic and now use a new unopened single small bottles or applicator for each patient.
 
Ani
 
 



> Subject: RE: [HSF] Post op mediastinitis> Date: Sat, 8 Sep 2007 09:00:19 -0700> From: ecdouville at orclinic.com> To: OpenHeart-L at lists.hsforum.com> CC: > > This can be a terribly difficult problem to solve. I am aware of a hospital where the usual investigations turned up nothing; measures such as observers' timing surgeon scrub times at the sink were instituted to no avail. Eventually a slow leak from an upstairs toilet was identified to drop into the cabinet where some sterile packs were stored in the OR leading to naturally, gram negative infections. In our own institution, one infection blip led to routine nasal culture of all team members to identify Staph carriers and treat them. We now culture pts nares pre-operatively and if positive, treat them with mupirocin pre-operatively. > > Ahmed my suggestion is, if you think there is a problem, look beyond the obvious things we would all think of and encourage your consultants to help you do so. Your infection control nurse can sometimes help with this as well.> > ________________________________> > From: openheart-l-bounces at lists.hsforum.com on behalf of psimha> Sent: Sat 9/8/2007 6:44 AM> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Post op mediastinitis> > > > Gram positive or negative infections ?> Prasanna> A wrote:> > Dear Forum Members:> >> > During the past few weeks we had more than our fair share of deep> > mediastinitis. We are taking all the usual precautions nothing has changed> > but it seems that we are in it for the duration. We consulted ID team and> > the Infection control at the hospital. Does any one of the members have more> > advice for this frustrating problem? I know the issue is boring and not> > exciting but I would appreciate all inputs. Thank you> >> > > >> > Ahmed> >> > > >> > _______________________________________________> > OpenHeart-L mailing list> >> > Send postings to:> > OpenHeart-L at lists.hsforum.com> >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> > http://mmp.cjp.com/mailman/listinfo/openheart-l> >> > All messages transmitted by the OpenHeart-L are subject to the policies and> > disclaimers posted at:> > http://www.hsforum.com/listdisclaim> > -----------------------------------------> >> >> > > > _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and> disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------> > 
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