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Association between methicillin-resistant Staphylococcus aureus nasal carriage and infection after pancreatic surgery
Koichi Jinushi1, Junzo Shimizu1, Masafumi Yamashita1
1Department of Surgery, Toyonaka Municipal Hospital, Osaka, Japan.
Background:
Methicillin-resistant Staphylococcus aureus (MRSA) infections after pancreatectomy are relatively rare; however, they can be fatal when associated with pseudoaneurysms. For the past 12 years, we have been investigating nasal MRSA carriage by polymerase chain reaction testing, postoperatively in patients admitted to the intensive care units, to prevent nosocomial infections. Here, we investigated the relationship between MRSA nasal carriage and postoperative MRSA infection at the surgical site, following pancreatectomy.
Methods:
This single-center retrospective study analyzed 313 pancreatectomies (220 pancreaticoduodenectomies and 93 distal pancreatectomies), performed at our hospital between January 2011 and June 2022. The incidence of surgical site infection (SSI) and postoperative MRSA infection were compared between the nasal MRSA-positive and nasal MRSA-negative groups.
Results:
MRSA nasal carriage was identified in 24 cases (7.6%), and the frequency of SSIs in the nasal MRSA-positive and MRSA-negative groups were 50% and 36.7%, respectively, with no significant difference (p = .273). However, the frequency of MRSA infection among the SSI cases was significantly higher in the nasal MRSA-positive group (16.7%) than in the nasal MRSA-negative group (1.7%) (p = .003).
Conclusion:
It should be noted that MRSA carriers have a significantly higher frequency of MRSA-positive SSIs.
Insights
Methicillin-resistant Staphylococcus aureus (MRSA) nasal carriage is linked to a higher risk of MRSA surgical site infections after pancreatectomy. Early identification of MRSA carriers is crucial for preventing severe postoperative complications.
Area of Science:
- Surgical Oncology
- Infectious Diseases
- Critical Care Medicine
Background:
- Post-pancreatectomy infections with Methicillin-resistant Staphylococcus aureus (MRSA) are rare but potentially fatal, especially when complicated by pseudoaneurysms.
- Nasal MRSA carriage screening has been employed for 12 years to mitigate nosocomial infections in intensive care units.
- This study examines the correlation between MRSA nasal carriage and the occurrence of postoperative MRSA surgical site infections (SSIs) following pancreatectomy.
Purpose of the Study:
- To investigate the association between nasal MRSA carriage and the development of MRSA surgical site infections (SSIs) after pancreatectomy.
- To compare the incidence of SSIs and MRSA infections in patients with and without nasal MRSA carriage.
Main Methods:
- A single-center retrospective study included 313 pancreatectomies (220 pancreaticoduodenectomies, 93 distal pancreatectomies) from January 2011 to June 2022.
- Patients were categorized into nasal MRSA-positive and nasal MRSA-negative groups based on polymerase chain reaction testing.
- Incidence of SSIs and MRSA infections were compared between the two groups.
Main Results:
- MRSA nasal carriage was detected in 7.6% of patients.
- The overall SSI rate was 50% in the MRSA-positive group versus 36.7% in the MRSA-negative group (p=0.273), showing no significant difference.
- However, the incidence of MRSA infection among SSI cases was significantly higher in the MRSA-positive group (16.7%) compared to the MRSA-negative group (1.7%) (p=0.003).
Conclusions:
- Patients identified as MRSA carriers exhibit a significantly higher frequency of MRSA-positive SSIs post-pancreatectomy.
- These findings underscore the importance of screening for nasal MRSA carriage in patients undergoing pancreatectomy to identify high-risk individuals.
- Targeted interventions for MRSA carriers may help reduce the incidence of severe postoperative MRSA infections.
