Rapid colonization with methicillin-resistant coagulase-negative staphylococci after surgery

Area of Science:

• Microbiology
• Infectious Diseases
• Surgical Site Infections

Background:

• Antimicrobial resistance poses a threat to surgical antibiotic prophylaxis.
• Coagulase-negative staphylococci (CoNS) are common skin colonizers and a cause of surgical site infections.

Purpose of the Study:

• To assess the susceptibility and clonal distribution of CoNS on skin before and after major abdominal surgery.
• To evaluate the impact of surgery on CoNS colonization and resistance patterns.

Main Methods:

• 140 patients undergoing elective major abdominal surgery were screened for CoNS colonization at admission and 5 days post-surgery.
• Isolates underwent antibiotic susceptibility testing and genotyping via pulsed-field gel electrophoresis (PFGE).

Main Results:

• CoNS colonization decreased from 85% at admission to 55% post-surgery.
• Methicillin-resistant CoNS rates rose from 20% to 47% (P = 0.001).
• Post-surgery, a significant increase in patients colonized with identical CoNS clones was observed (P < 0.001).

Conclusions:

• Results indicate rapid recolonization with resistant, nosocomial CoNS after skin disinfection.
• Further research in orthopedic or cardiovascular surgery is needed to determine if standard antibiotic prophylaxis is compromised.