Article in Japanese

Postoperative Mediastinitis in Children

Yukitsugu NAKAMURA^1,2), Yuho HORIKOSHI¹⁾

Postoperative mediastinitis is a surgical site infection, which can be serious and life-threatening. To date, few studies of pediatric postoperative mediastinitis have been conducted in Japan. The aim of this study was to investigate the clinical and microbiological characteristics of postoperative mediastinitis in children. Patients with postoperative mediastinitis. Between March 2010 and March 2017 were enrolled into this study at the Tokyo Metropolitan Children's Medical Center, Japan. Patient characteristics and microbiological data were collected from electronic chart records. A total of 20 patients were identified. The median age at onset was 9 months (IQR: 4-12 months), and the median postoperative onset period was 11.5 days (IQR: 7-14 days). Ten cases (50%) had fever above 38°C at diagnosis, and 18 (90%) showed changes in local findings such as erythema and pus. Staphylococcus aureus was the most predominant pathogenic bacteria in 7 cases, followed by Staphylococcus epidermidis in 5. Bacteremia was complicated in 5 cases (25%), and the pathogenic bacteria of these patients were only gram-positive cocci. The hospital mortality rate was 4 cases (20%), of which 2 died during treatment for postoperative mediastinitis. Three cases were caused by gram-negative bacilli. Careful observation of the wound site is considered important for early diagnosis of pediatric postoperative mediastinitis.

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1) Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children's Medical Center
2) Department of Pediatrics, St. Marianna University School of Medicine

Key words	cardiothoracic surgery, mediastinitis, surgical site infection, children
Received	February 7, 2019
Accepted	September 3, 2019

31 (4)：335─340,2019