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Efficacy of continuous cleansing with teicoplanin on post-CABG methicillin-resistant staphylococcus aureus (MRSA) mediastinitis: report of a case.

Abstract
The patient was a 48-year-old male who was diagnosed with unstable angina. He had worsening cardiogenic shock during coronary angiography. Emergency coronary artery bypass grafting (CABG) was performed. He had a methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis on day 22 after CABG. Drains were placed in the anterior mediastinum, left thoracic cavity, and abscess cavity, and another drain was placed in the mediastinal space for continuous cleansing with povidone iodine, oxydol. For antibiotics, teicoplanin (TEIC) was administered intravenously and to the local site via the cleansing drain for about one month. No MRSA was detected by culture in discharges from the mediastinal drain. Inflammatory findings were improved, and the patient was discharged and resumed everyday life without recurrence of inflammation as of eight months. Although the number of cases of MRSA mediastinitis is small and accumulation of cases is necessary to investigate therapeutic methods and selection of antibiotics, our department will select closed continuous cleansing and TEIC for antibiotics as the first choice for MRSA mediastinitis, and accumulate cases to investigate its efficacy.
AuthorsAkira Sezai, Motomi Shiono, Tatsuya Inoue, Mitsumasa Hata, Mitsuru Iida, Tetsuya Niino, Akira Saito, Tsutomu Hattori, Shinji Wakui, Masao Soeda, Nanao Negishi, Yukiyasu Sezai
JournalAnnals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia (Ann Thorac Cardiovasc Surg) Vol. 10 Issue 3 Pg. 191-4 (Jun 2004) ISSN: 1341-1098 [Print] Japan
PMID15312017 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Anti-Bacterial Agents
  • Teicoplanin
Topics
  • Anti-Bacterial Agents (therapeutic use)
  • Coronary Artery Bypass
  • Humans
  • Male
  • Mediastinitis (drug therapy, microbiology)
  • Methicillin Resistance
  • Middle Aged
  • Staphylococcal Infections (drug therapy, microbiology)
  • Staphylococcus aureus (drug effects)
  • Surgical Wound Infection (drug therapy, microbiology)
  • Teicoplanin (therapeutic use)

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