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MRSA infections following colorectal surgery in an enhanced recovery programme
A W Phillips1, K J Cranfield, A F Horgan
1Department of Colorectal Surgery, Freeman Hospital, Newcastle upon Tyne, UK. awphillips@doctors.net.uk
Aim:
The aim of this study was to evaluate the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections in a cohort of patients undergoing elective colorectal resections within an enhanced recovery programme.
Method:
A prospective database of all patients undergoing colorectal resections by a single surgical team over a 3.5-year period was reviewed. Demographics including age, gender, body mass index, American Society of Anesthesiologists classification, type of surgery (abdominal or pelvic) and whether or not the procedure was laparoscopic or open were analysed. All patients were screened preoperatively and postoperatively and on discharge for MRSA. Patients found preoperatively to be MRSA positive were excluded from the study.
Results:
In all, 186 patients underwent colorectal resection over the time reviewed. There were 113 laparoscopic resections, 70 open resections and three laparoscopic converted to open resections. Five patients (2.7%) were found to be MRSA positive postoperatively. All of these had open rather than laparoscopic surgery (P < 0.01). Length of stay for patients that had MRSA infections was significantly longer than those remaining MRSA free (P < 0.05).
Conclusion:
These results suggest that patients who successfully undergo laparoscopic colorectal resections within an enhanced recovery programme have a lower incidence of postoperative MRSA infections.
Insights
Laparoscopic colorectal resections within enhanced recovery programs show a lower incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections. Open surgeries had a higher MRSA infection rate, indicating a potential benefit of minimally invasive approaches.
Area of Science:
- Surgical infection control
- Minimally invasive surgery outcomes
- Enhanced recovery protocols
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant risk in surgical settings.
- Colorectal resections are common procedures with potential for postoperative complications.
- Enhanced recovery programmes aim to optimize patient outcomes and reduce surgical site infections.
Purpose of the Study:
- To determine the incidence of MRSA infections in patients undergoing elective colorectal resections.
- To compare MRSA infection rates between laparoscopic and open surgical approaches.
- To evaluate the impact of MRSA infections on patient length of stay within an enhanced recovery setting.
Main Methods:
- Prospective analysis of 186 patients undergoing colorectal resection over 3.5 years.
- Inclusion of demographic and surgical data (laparoscopic vs. open, abdominal vs. pelvic).
- Preoperative, postoperative, and discharge screening for MRSA; preoperative positives were excluded.
Main Results:
- Five patients (2.7%) developed postoperative MRSA infections.
- MRSA infections were significantly more common in open resections compared to laparoscopic (P < 0.01).
- Patients with MRSA infections had a significantly longer hospital stay (P < 0.05).
Conclusions:
- Laparoscopic colorectal resections within enhanced recovery programmes are associated with a lower incidence of postoperative MRSA infections.
- Minimally invasive approaches may reduce the risk of MRSA acquisition and subsequent complications.
- Further research is warranted to confirm these findings and explore underlying mechanisms.
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