Coagulase-negative staphylococci and cloxacillin prophylaxis in pacemaker surgery.

In a prospective study of cloxacillin prophylaxis at pacemaker surgery per- and post-operative cultures were made. The most commonly isolated organisms from the wound were coagulase-negative staphylococci. These were typed by the scheme devised by Kloos and Schleifer. The routinely performed per-operative culture was of very little prognostic value. However, the typing was found to be useful in cases with suspected infection, as repeated isolation of the same species of coagulase-negative staphylococci with the same antibiotic susceptibility pattern may indicate pathogenicity. Incubation in enrichment medium for 2-4 days was needed in one patient who received antibiotic therapy when the specimen for culture was taken. The antibiotic prophylaxis did not eradicate even susceptible bacteria from the wound, but the infection rate was significantly lower in the prophylaxis group.