Postoperative wound infection with methicillin-resistant staphylococci in general surgical patients

A prospective survey of 1757 general surgical patients undergoing operation was performed comparing 35 patients with wound infection yielding methicillin-resistant Staphylococcus aureus (MRSA) with 184 patients developing wound infections due to other organisms. The following parameters were statistically significantly increased in the patients with MRSA wound infection; MRSA infection or colonization at other sites, 37% versus 2%, severe wound infection 31% versus 12%, wound drain tubes 23% versus 10%, multiple operations 37% versus 6%, malignant disease 43% versus 23%, postoperative complications 46% versus 16%, intensive care admissions 23% versus 5% and prophylactic antibiotics 51% versus 30%. There was no difference in postoperative mortality 11% versus 7%; mean age, 58 years versus 56 years; sex; diabetes, 11% versus 9%; or emergency operations 40% versus 39%. There were 18 patients with single organism MRSA wound infection who were compared with 35 patients with single organism methicillin-sensitive S. aureus (MSSA) wound infection. The patients with MRSA wound infections had a statistically significant increase in the following parameters: mean preoperative stay in hospital 8 days versus 4 days; prophylactic antibiotics 39% versus 3%; MRSA infection or colonization at other sites 39% versus 6%; and malignant disease 44% versus 17%. There were no deaths in either group and there was no statistically significant difference in other parameters, namely, multiple operations 11% versus 3%; intensive care admissions 6% in each group; wound drain tube 17% versus 11%; severe infections 22% versus 6%; and postoperative complications 22% versus 9%. These latter parameters were statistically significantly increased when all MRSA wound infections were compared with all wound infections due to other organisms.