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Nasal MRSA colonization increased risk for surgical site infections
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Nasal colonization of methicillin-resistant Staphylococcus aureus was associated with an increased incidence of surgical site infections among patients undergoing major gastrointestinal surgery, according to research presented at Digestive Disease Week in San Diego.
“Surgical site infections involving MRSA are associated with longer hospital stays, increased mortality and significant increases in health care costs,” Harry T. Papaconstantinou, MD, chief of colorectal surgery at Scott and White Memorial Hospital in Temple, Texas, said during a press briefing. “Admission screening for MRSA has been initiated by many hospitals to identify and isolate patients who are colonized with MRSA.”
A team of researchers, led by Papaconstantinou, began universal nasal swab testing on patients undergoing major gastrointestinal surgery. From December 2007 to August 2009, 1,137 patients underwent gastrointestinal surgery and nasal swab testing. Of the patients tested, 6.7% had MRSA, 14.7% had methicillin-sensitive S. aureus and 78.9% tested negative.
After surgery, 101 patients developed a surgical site infection. The MRSA group had a higher rate of surgical site infections: 13.7% vs. 9.4% for those with negative swabs vs. 4.2% for those with MSSA.
Harry T. Papaconstantinou
The researchers obtained wound culture results from 92 of the 101 patients with surgical site infections. Those with positive MRSA nasal swabs had a higher rate of MRSA positive wound cultures: 70% vs. 8.5% for those without positive MRSA nasal swabs.
The median length of hospital days was 12.5 days among those with MRSA — 4 days longer than those without MRSA. Presence of a surgical site infection increased length of stay from 6.2 days to 15.7 days, but there was no difference in length of stay with surgical site infection between the groups.
“The take-home message is that a positive MRSA nasal swab test is a strong predictor that MRSA-related surgical site infection may occur in patients undergoing major gastrointestinal surgery,” Papaconstantinou said. “It may be beneficial to preoperatively screen and decolonize these patients to reduce the incidence of these infections and to improve patient outcomes following operations.”
References:
- Papaconstantinou H. #374. Presented at: Digestive Disease Week 2012; May 19-22, 2012; San Diego.
Disclosures:
- Dr. Papaconstantinou reports no relevant financial disclosures.