Dalbavancin for deep sternal wound infection treatment: clinical characteristics, microbiology and management.

The aim of this study is to describe clinical characteristics, microbiology and outcome of deep sternal wound infection (DSWI) treated with dalbavancin. It is a retrospective study conducted in 2 hospitals having a cardiac surgery unit. All cases were managed with surgical debridement, deep microbiological sampling and application of vacuum assisted closure. We analysed 6 cases of DSWI. Of all, 4 (66%) cases were female and 2 male, with a median age of 65 years (48-70). The most frequent comorbidities were diabetes (3, 50%) and ischemic heart disease (3, 50%). The Body Mass Index show that 2 of 6 (33%) patients were “overweight”, 2 of 6 (33%) “obese” and the other 2 were in normal range (33%). Three patients (50%) were subjected to coronary artery bypass graft, the others underwent to valve replacement both for aortic stenosis and mitralic insufficiency. As regards etiology, Staphylococcus aureus methicillin-resistant was found in 2 cases, Staphylococcus epidermidis methicillin-resistant was found in 2 cases. The remains were due to coagulase negative Staphilococci methicillin-resistant. Dalbavancin was administered intravenous at 1000 mg dose followed by 500 mg the weeks later. All the patients obtained resolution of infection. Clinical characteristics and etiology of DSWI in our little population confirm literature data. The use of dalbavancin in a population with high probability of nosocomial pathogens seems a good option, especially with a combined surgical approach.

Renato Pascale
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