Related Experiment Video
Updated: Dec 17, 2025
Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
Published on: February 9, 2011
Pre-operative methicillin resistant Staphylococcus aureus results do not predict surgical site infections in children
Alexander Nazareth1,2, Sukhraj S Bains1, Lindsay M Andras1,2
1Keck School of Medicine, University of Southern California.
Abstract:
Literature regarding the value of pre-operative nasal methicillin resistant Staphylococcus aureus (MRSA) swabs to predict surgical site infections (SSIs) in children undergoing lower extremity surgery is limited. The purpose of our study was to determine if pre-operative nasal MRSA swab results were predictive of SSI development in children undergoing a femoral varus derotational osteotomy (VDRO).Patients who underwent VDRO between 2004-2016 were reviewed to determine pre-operative MRSA colonization rates and SSI devolvement rates. Patients with less than 1 year of follow-up, previous history of infections, or absent pre-operative MRSA swab were excluded. SSI rates of patients with negative MRSA and positive MRSA swab result were compared using the Fisher exact test. Aside from contact isolation precautions, no other changes in treatment were made during inpatient hospital course based on positive pre-operative nasal MRSA swab results.247 patients met the inclusion criteria (mean age: 9.3 ± 3.6 years, 62% male). There were 242 (98%) patients with a negative MRSA swab and 5 (2%) patients with a positive MRSA swab. Out of the 242 patients with a negative MRSA swab, 4 developed an SSI. Of the patients with positive MRSA swab results, 0% (0/5) developed an SSI compared to 1.7% (4/242) of negative MRSA swab results who developed an SSI. Results indicated no significant difference in SSI development rates between the groups (P = 1.00).In this series of children undergoing VDRO surgery, the results of a pre-operative MRSA nasal swab had no relationship to SSI incidence and no impact on clinical patient care. Pre-operative MRSA nasal swabs appear to be of limited benefit for routine pre-operative screening in this patient population.Level III, retrospective comparative.
Insights
Pre-operative nasal methicillin-resistant Staphylococcus aureus (MRSA) swabs did not predict surgical site infections (SSIs) in children undergoing femoral varus derotational osteotomy (VDRO). Routine screening for MRSA colonization is not recommended for these pediatric patients.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Epidemiology
- Pediatric Healthcare
Background:
- Surgical site infections (SSIs) are a significant concern in pediatric orthopedic surgery.
- The predictive value of pre-operative nasal methicillin-resistant Staphylococcus aureus (MRSA) colonization for SSIs in children undergoing lower extremity surgery is not well-established.
- Limited literature exists on the utility of MRSA screening prior to specific pediatric orthopedic procedures.
Purpose of the Study:
- To determine if pre-operative nasal MRSA swab results predict the development of SSIs.
- To evaluate the association between MRSA colonization and SSI incidence in pediatric patients undergoing femoral varus derotational osteotomy (VDRO).
- To assess the clinical impact of pre-operative MRSA screening in this patient cohort.
Main Methods:
- Retrospective review of pediatric patients who underwent VDRO between 2004 and 2016.
- Analysis of pre-operative nasal MRSA colonization rates and subsequent SSI development.
- Comparison of SSI rates between MRSA-positive and MRSA-negative patients using the Fisher exact test (excluding patients with <1 year follow-up, prior infections, or missing swabs).
Main Results:
- 247 patients met inclusion criteria; 98% (242) were MRSA-negative, and 2% (5) were MRSA-positive.
- Four SSIs occurred in the MRSA-negative group (1.7%), while zero SSIs occurred in the MRSA-positive group (0%).
- No statistically significant difference in SSI development was observed between MRSA-colonized and non-colonized patients (P=1.00).
Conclusions:
- Pre-operative nasal MRSA screening showed no relationship to SSI incidence in children undergoing VDRO.
- MRSA nasal swabs had no discernible impact on clinical patient care or SSI rates in this study.
- Routine pre-operative MRSA nasal screening appears to offer limited benefit for pediatric patients undergoing VDRO surgery.
