Care bundle to prevent methicillin-resistant Staphylococcus aureus sternal wound infection after off-pump coronary artery bypass

Methicillin-resistant Staphylococcus aureus (MRSA) sternal wound infection (SWI) after cardiac surgery is endemic in our hospital. An infection control care bundle with preoperative chlorhexidine showering and povidone iodine paint before bathing was introduced in 2006. From 2001 to 2012, 23 (2.3%) of 1,010 patients undergoing off-pump coronary artery bypass had SWIs. SWI significantly decreased after 2006 (1.4% vs 3.4%, respectively; P =.03). Care bundle was more protective against MRSA infection (2.3% vs 0.5%, respectively; P =.021). SWI remained a common complication after off-pump coronary artery bypass. MRSA infection was most common, and the mortality was high. Care bundle can effectively decrease the incidence of SWI, especially infection caused by MRSA.