Twenty years of countermeasures against postoperative methicillin-resistant Staphylococcus aureus infections

Area of Science:

• Infectious Disease Epidemiology
• Surgical Site Infection Prevention
• Antimicrobial Stewardship

Background:

• Rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections poses a significant challenge in healthcare settings.
• Effective strategies are crucial to mitigate MRSA transmission and infection rates, particularly in surgical patients.

Purpose of the Study:

• To investigate the impact of evolving infection control measures on MRSA rates in digestive organ surgery over a 20-year period.
• To evaluate the effectiveness of different prophylactic antibiotic regimens and isolation protocols in reducing MRSA infections.

Main Methods:

• A 20-year retrospective study of 7345 digestive organ surgery cases, divided into five periods (A-E) based on intervention changes.
• Implementation of varied prophylactic antibiotic durations (4 days, 1 day, 3 days) and nonscreening pre-emptive isolation and cohorting (NSPEI&C) protocols.
• Comparative analysis of MRSA isolation rates across the defined study periods.

Main Results:

• MRSA isolation rates varied significantly across periods, with a notable decrease in Period B (0.3%) and Period E (0.4%).
• Period C saw an increase in MRSA rates (3.4%) after halting NSPEI&C, indicating the protocol's importance.
• Period E demonstrated a significant reduction in MRSA cases (0.4%) compared to Period D (2.2%), highlighting the success of updated comprehensive management.

Conclusions:

• A combination of comprehensive management, judicious selection of prophylactic antibiotics, and NSPEI&C proved effective in controlling MRSA infections.
• The study underscores the importance of adaptive and multi-faceted infection control strategies in surgical settings.
• Sustained efforts in infection prevention are vital for reducing the burden of MRSA in digestive organ surgery.