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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)
12:18

Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus (MRSA)

Published on: February 9, 2011

Institutional prescreening for detection and eradication of methicillin-resistant Staphylococcus aureus in patients

David H Kim1, Maureen Spencer, Susan M Davidson

  • 1Department of Orthopaedic Surgery, New England Baptist Hospital, 125 Parker Hill Avenue, Boston, MA 02120, USA. dhkim@caregroup.harvard.edu

The Journal of Bone and Joint Surgery. American Volume
|July 9, 2010
PubMed
Abstract

Insights

Preoperative screening for Staphylococcus aureus carriers in orthopedic surgery patients is feasible and effective. This program significantly reduced surgical site infections, demonstrating its value in preventing complications.

Area of Science:

  • Infectious Disease
  • Surgical Outcomes
  • Public Health

Background:

  • Surgical site infections (SSIs) are a major cause of patient morbidity and mortality.
  • Preventing SSIs is crucial for improving patient outcomes and reducing healthcare costs.
  • Staphylococcus aureus, including methicillin-resistant strains (MRSA), is a common pathogen causing SSIs.

Purpose of the Study:

  • To assess the feasibility and effectiveness of a prescreening program for Staphylococcus aureus (S. aureus) carriers.
  • To detect and eradicate both methicillin-resistant (MRSA) and methicillin-sensitive (MSSA) S. aureus preoperatively.
  • To reduce SSI rates in patients undergoing elective orthopedic surgery.

Main Methods:

  • Prospective single-center study involving universal preoperative screening of nasal swabs using rapid polymerase chain reaction.
  • Implementation of an eradication protocol for identified S. aureus carriers (intranasal mupirocin and chlorhexidine showers).
  • Comparison of SSI rates with a historical control period preceding the screening program.

Main Results:

  • A 95.7% screening success rate was achieved in 7019 patients.
  • S. aureus carriers identified in 22.6% of patients; MRSA carriers in 4.4%.
  • The overall institutional SSI rate decreased significantly from 0.45% in the control period to 0.19% post-implementation (p=0.0093).

Conclusions:

  • An institutional prescreening program for S. aureus carrier status is feasible.
  • This program effectively reduces postoperative SSI rates in elective orthopedic surgery.
  • Preoperative identification and eradication of S. aureus carriers improve surgical outcomes.

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