Staphylococcus aureus infection complicating percutaneous coronary interventions

Background: This study sought to determine the incidence, risk factors, and characteristics of Staphylococcus (S.) aureus infections complicating percutaneous coronary interventions (PCI). Methods: Between January 1999 and December 2002, 7640 PCI's were evaluated from 1 to 16 days post-PCI for the occurrence of a documented S. aureus infection. A case-control study was used to identify risk factors for the development of S. aureus infection in patients undergoing PCI. Results: In total 21 S. aureus infections (0.27%) were documented at 1 to 16 days after the index PCI. The overall incidence of PCI-related infection was 0.14% (11 cases), 0.13% ( 10 cases) were intravascular line related. All 21 cases with S. aureus infections were matched with 63 controls randomly selected among patients who underwent a PCI but did not have S. aureus infections. Among the patients with S. aureus infections, the duration of hospital stay was significantly increased (24 vs 5 days). The overall mortality rate in the 21 patients with S. aureus infections was 4/21 [19%] (controls 2/42 [3%]). Congestive heart failure, alcohol abuse, emergency PCI, more than 1 PCI in three months and the presence of a sheath in the femoral artery and/or vein for the duration of more than 1 day after the procedure were independent risk factors for S. aureus infection after PCI. Conclusions: S. aureus infection is a rare but potentially serious complication of PCI. Additional precautions should be considered in patients with these risk factors. c 2007 Elsevier Ireland Ltd. All rights reserved.