Methicillin-resistant Staphylococcus aureus screening is important for surgeons.

Area of Science:

• Infectious Disease Epidemiology
• Surgical Infection Prevention
• Healthcare-Associated Infections

Background:

• Surgical site infections (SSIs) are a significant cause of morbidity following surgical procedures.
• An unusual outbreak of methicillin-resistant Staphylococcus aureus (MRSA)-related SSIs prompted an investigation into its origin.

Purpose of the Study:

• To determine the origin of MRSA-related SSIs during a hospital outbreak.
• To identify risk factors associated with MRSA SSIs in hepatobiliopancreatic surgery patients.

Main Methods:

• Epidemiologic analysis of 102 patients undergoing hepatobiliopancreatic operations, with 8 developing SSIs.
• Infection surveillance of the operative environment and analysis of potential risk factors.
• Propensity score matching to identify significant risk factors for MRSA SSIs.

Main Results:

• Patients with SSIs had characteristics including older age, cancer operations, and longer operation times.
• After propensity score matching, the participation of a specific surgeon (Surgeon D) as a second assistant was the sole significant risk factor for MRSA SSI.
• Surgeon D’s involvement as a second assistant demonstrated a high hazard ratio (25.088) for MRSA SSI.

Conclusions:

• The MRSA SSI outbreak resulted from surgeon-to-patient transmission, linked to the surgeon's nasal and hand carriage of the identified MRSA strain.
• Standard infection control measures were insufficient to prevent transmission in this outbreak.
• Preoperative regular nasal and hand screening for MRSA among surgeons is recommended to prevent future outbreaks.