Methicillin-resistant Staphylococcus aureus preventing strategy in cardiac surgery

Area of Science:

• Infectious Diseases
• Hospital Epidemiology
• Surgical Site Infections

Background:

• Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant threat in healthcare settings, particularly in vulnerable patient populations like those undergoing cardiovascular surgery.
• Effective prevention strategies are crucial to mitigate the morbidity and mortality associated with MRSA infections.

Purpose of the Study:

• To evaluate the effectiveness of an institutional MRSA prevention strategy.
• To determine the incidence, morbidity, and mortality associated with MRSA in cardiovascular surgical patients.

Main Methods:

• A prospective observational cohort study of 15,270 cardiovascular surgical patients from 1997 to 2005.
• Implementation of active screening for MRSA carriers via nasal swabs in high-risk patients and newly employed healthcare workers.
• Isolation and prompt treatment of MRSA carriers and infected patients.

Main Results:

• The overall infection rate was 5.4%, with an MRSA-associated infection rate of 0.2% (86 MRSA cases out of 15,270 patients).
• MRSA-infected patients experienced a significantly longer ICU stay (46.5 days vs. 1.7 days) and a higher mortality rate (30% vs. 2.9%) compared to non-MRSA infected patients.
• MRSA was identified in various sites, including tracheal secretions, surgical wounds, drainage fluid, and blood cultures, leading to complications like post-sternotomy mediastinitis and severe sepsis.

Conclusions:

• A multi-faceted MRSA prevention strategy, encompassing early detection, isolation, and treatment of infected patients and carriers, effectively curbed pathogen spread.
• The findings underscore the importance of rigorous screening and management protocols for MRSA in high-risk surgical populations.