Perioperative antimicrobials in chest surgery patients positive for methicillin-resistant Staphylococcus aureus

In pulmonary surgery, methicillin-resistant Staphylococcus aureus (MRSA)-positive patients present an issue of perioperative antimicrobials. During 1996 to 2009 in a total of 1,080 pulmonary operations, MRSA was detected before 20 operations. Perioperatively, we followed the Sanford Guide using vancomycin (VCM) or arbekacin (ABK) in MRSA-positive cases at high risk (n = 14), including 1 with clinical infection and 13 with colonization. We used 1-day cefazolin (CEZ) in MRSApositive cases at low risk (n = 6). We defined the outcome as surgical site infection (SSI) that included death from infection. The 14 high-risk cases received a median of 3 days of VCM or ABK, of which 1 (7%) developed SSI. Of the cases given CEZ, we noted SSI in 1 of 6 low-risk cases (17%). Thus, MRSA-positive pulmonary surgery patients at large may receive 3-day VCM or ABK.