Prescreening for MRSA Could Reduce Surgical Infection Rates

Preoperative screening of patients for methicillin-resistant Staphylococcus aureus (MRSA) may be an effective way to reduce infection rates following otolaryngic surgeries, according to a new study.

Researchers at the Massachusetts Ear & Eye Infirmary (Boston, USA) reviewed the medical records of 420 patients and examined postoperative MRSA infection rates during a one-year period. The infection rates were then compared with those in patients treated after preoperative S. aureus screening was initiated at the infirmary. Patients with S. aureus were treated with mupirocin and chlorhexidine preoperatively. The results of the study showed that of the 241 non-prescreened patients during a one-year period, nine patients had S. aureus infections, including two postoperative MRSA surgical site infections. Of the 179 patients pre-screened using a nasal swab, 24 patients were identified as having S. aureus colonies, and underwent preoperative treatment; none of these patient cases resulted in postoperative MRSA infections. Due to particular concerns about MRSA infections in otolaryngic surgeries, the authors recommend further, larger studies, with an emphasis on high-risk patients, including those with multiple comorbidities, head and neck cancer patients, patients receiving implanted devices, and patients with prior hospitalizations or multiple courses of antibiotics. The study was published in the January 2009 issue of Otolaryngology - Head and Neck Surgery.

"Early results show the potential benefit of preoperative S. aureus screening in MRSA infection rate reduction,” concluded coauthor Sara Richer, M.D., and colleagues of the department of otolaryngology. "Screening and treatment of MRSA colonized patients preoperatively may reduce infectious complications in otolaryngology.”

MRSA, discovered in 1961, is a resistant variation of the common bacterium S. aureus. It has evolved an ability to survive treatment with beta-lactamase resistant beta-lactam antibiotics, including methicillin, dicloxacillin, nafcillin, and oxacillin, as well as cephalosporins. MRSA commonly colonizes in the nostrils, can cause life-threatening pneumonias, can necrotize skin and wound infections, and is a particular risk to children, the elderly, and people with weak immune systems.

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Massachusetts Ear & Eye Infirmary