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Updated: Aug 9, 2026
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
Published on: February 9, 2011
Percutaneous endoscopic gastrostomy sites infected by methicillin-resistant Staphylococcus aureus: impact on outcome
Inder Mainie1, Anne Loughrey, Jennifer Watson
1Division of Gastroenterology, Ulster Hospital, Dundonald, Belfast, N. Ireland, United Kingdom. mainie@musc.edu
Background:
The impact of methicillin-resistant Staphylococcus aureus (MRSA) colonization of percutaneous endoscopic gastrostomy (PEG) sites on morbidity and mortality is uncertain.
Aim:
We investigated the impact of known prior MRSA colonization on the incidence of symptomatic PEG site wound infection and mortality.
Methods:
Consecutive patients who had PEG tubes inserted recently at our hospital were identified. The presence or absence of MRSA colonization before PEG placement was noted. Patients were observed for wound infection, and swabs were taken from the site if there was clinical infection. Mortality within 30 days of PEG placement was determined.
Results:
A total of 83 patients underwent PEG placement; 23 (28%) of these patients had known MRSA colonization before PEG placement. Of these, 13 (57%) developed symptomatic MRSA infection of the PEG site. The remaining 60 patients (72%) had no known prior MRSA colonization. In these patients, 9 (15%) developed symptomatic MRSA infection of the PEG site. The overall incidence of wound infection was 37% (31) of the total undergoing PEG placement, of whom 71% (22) had developed MRSA infection. The mortality of those with symptomatic MRSA infection of the PEG site was 9% (2/22), whereas the mortality from non-MRSA-infected PEGs was 20% (12/61).
Conclusion:
Patients with prior MRSA colonization had a significantly higher risk of developing symptomatic MRSA infection of the PEG site. However, there was still a significant risk (15%) of developing MRSA infection of the PEG site for patients with no known prior MRSA infection. MRSA infection of the PEG site did not affect mortality.
Insights
Prior methicillin-resistant Staphylococcus aureus (MRSA) colonization significantly increases the risk of symptomatic PEG site infection. However, MRSA infection at the PEG site did not impact patient mortality in this study.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Surgical Site Infections
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) colonization of percutaneous endoscopic gastrostomy (PEG) sites is a concern.
- The precise impact of MRSA colonization on PEG site morbidity and mortality remains unclear.
Purpose of the Study:
- To investigate the association between known prior MRSA colonization and the incidence of symptomatic PEG site wound infections.
- To determine the effect of MRSA colonization on 30-day mortality following PEG tube placement.
Main Methods:
- A cohort of patients undergoing recent PEG placement was reviewed.
- Pre-placement MRSA colonization status was recorded.
- Patients were monitored for symptomatic wound infections, with swabs taken for clinical infection. 30-day mortality was assessed.
Main Results:
- Of 83 patients, 23 (28%) had prior MRSA colonization, with 13 (57%) developing symptomatic MRSA PEG site infection.
- In patients without prior MRSA colonization (n=60), 9 (15%) developed symptomatic MRSA PEG site infection.
- Overall wound infection occurred in 37% of patients, with MRSA identified in 71% of these infections. Mortality was 9% for MRSA infections versus 20% for non-MRSA infections.
Conclusions:
- Prior MRSA colonization is a significant risk factor for developing symptomatic MRSA PEG site infections.
- A notable percentage of patients without prior MRSA colonization also developed MRSA PEG site infections.
- Symptomatic MRSA infection of the PEG site did not significantly affect overall patient mortality.
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