Korean J Nosocomial Infect Control.  2006 Jun;11(1):27-34.

Preoperative Nasal Carriage of Methicillin-Resistant Staphylococcus aureus and the Risks of Nosocomial Infection in Cardiac Surgery Patients

• Oh HS
• Kum KA
• Oh MD
• Lee HJ
• Kim EC
• Choe KW

Abstract

BACKGROUND: This study was conducted to investigate whether the preoperative nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) was a risk factor for surgical site infections and nosocomial infections in open heart surgery patients.
METHODS
From June 10, 2002 to October 30, 2002, data were collected by prospective surveillance carried out by infection control nurses. Nasal swabs were taken from patients (N= 106) on the day before surgery. The swabs were incubated in staphylococcal broth for 24 hours, and then it was incubated on mannitol salt agar for 24 hours. Muller-Hinton agar supplemented with oxacillin (6 microgram/mL) was used to identify MRSA.
RESULTS
Among the study patients (N=106), four(4/106, 3.8%) were identified as MRSA carriers and nine (9/103 , 8.7%) developed nosocomial infections, including three patients (3/103 , 2.9%) who had postoperative mediastinitis Preoperative nasal carriage of MRSA was not associated with nosocomial infections nor surgical site infections (P>0.05). However, the length of hospital stay prior to nasal swab or surgery was found to be associated with MRSA carriage (OR=1.108, 95%CI: 1.026-1.197) or nosocomial infections (OR=1.087, 95%CI: 1.017-1.161). Additionally, the patients with nosocomial infections were more likely than those without to stay in the hospital for a longer period after surgery (P<0.00l).
CONCLUSION
Preoperative nasal carriage of MRSA by the patient was not identified as a risk factor for surgical site infection and nosocomial infections in open heart surgery.

Keyword

Cardiac surgery; Hospital infection; Methicillin-resistant Staphylococcus aureus (MRSA); Nasal carrier; Surgical site infection

MeSH Terms

Agar
Cross Infection*
Humans
Infection Control
Length of Stay
Mannitol
Mediastinitis
Methicillin Resistance*
Methicillin-Resistant Staphylococcus aureus*
Oxacillin
Prospective Studies
Risk Factors
Thoracic Surgery*
Agar
Mannitol
Oxacillin