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[Postoperative MRSA infections in digestive tract surgery]
Abstract:
MRSA strains were first isolated in 1981 and have increased markedly from 1985 in our surgical ward. One hundred and ninety four strains of MRSA were isolated and 81 cases developed critical infections which were associated with enterocolitis, pneumonia and sepsis. There were many cases in esophageal cancer patients. Bacteriological features of the MRSA strains clearly changed in 1985 from IV to II coagulase type, accompanied with high resistance for antibiotics. Our management against nosocomial infection for MRSA started from April 1988. The number of MRSA cases decreased in 1989, increased in 1990 and decreased again in 1991. We are confident that our management is effective and we will take further efforts to choose the most adequate antibiotics after surgery in our surgical ward.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) infections rose in surgical wards, but a new management strategy starting in 1988 effectively reduced cases. Further efforts will optimize antibiotic selection post-surgery.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Hospital Epidemiology
Context:
- Methicillin-resistant Staphylococcus aureus (MRSA) strains emerged in 1981 and increased significantly in surgical wards from 1985.
- A notable shift in MRSA bacteriological features occurred in 1985, with a change in coagulase type and increased antibiotic resistance.
Purpose:
- To evaluate the impact of a nosocomial infection management strategy implemented in April 1988 on MRSA cases in a surgical ward.
- To analyze the trends of MRSA infections and associated critical illnesses.
Summary:
- 194 MRSA strains were isolated, leading to 81 critical infections including enterocolitis, pneumonia, and sepsis, particularly in esophageal cancer patients.
- Following the implementation of a management strategy in April 1988, MRSA cases initially decreased in 1989, then increased in 1990, followed by a further decrease in 1991.
- The study observed a change in MRSA coagulase types from IV to II in 1985, coinciding with heightened antibiotic resistance.
Impact:
- The implemented management strategy demonstrated effectiveness in controlling MRSA nosocomial infections within the surgical ward.
- Findings suggest the need for ongoing efforts to select optimal antibiotic regimens for surgical patients to combat MRSA.
- Highlights the dynamic nature of MRSA strains and their resistance patterns, emphasizing the importance of continuous surveillance and adaptive control measures.