Poor Functional Status as a Risk Factor for Surgical Site Infection Due to Methicillin-Resistant Staphylococcus aureus

2008 ◽  
Vol 29 (9) ◽  
pp. 832-839 ◽  
Author(s):  
Deverick J. Anderson ◽  
Luke F. Chen ◽  
Kenneth E. Schmader ◽  
Daniel J. Sexton ◽  
Yong Choi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Functional Status ◽  
Surgical Patients ◽  
Control Group ◽  
Site Infection ◽  
Methicillin Resistant ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
Poor Functional Status

Objective.To identify risk factors for surgical site infection (SSI) due to methicillin-resistant Staphylococcus aureus (MRSA).Design.Prospective case-control study.Setting.One tertiary and 6 community-based institutions in the southeastern United States.Methods.We compared patients with SSI due to MRSA with 2 control groups: matched uninfected surgical patients and patients with SSI due to methicillin-susceptible S. aureus (MSSA). Multivariable logistic regression was used to determine variables independently associated with SSI due to MRSA, compared with each control group.Results.During the 5-year study period, 150 case patients with SSI due to MRSA were identified and compared with 231 matched uninfected control patients and 128 control patients with SSI due to MSSA. Two variables were independendy associated with SSI due to MRSA in both multivariable regression models: need for assistance with 3 or more activities of daily living (odds ratio [OR] compared with uninfected patients, 3.97 [95% confidence interval {CI}, 2.18-7.25]; OR compared with patients with SSI due to MSSA, 3.88 [95% CI, 1.91-7.87]) and prolonged duration of surgery (OR compared with uninfected patients, 1.98 [95% CI, 1.11-3.55]; OR compared with patients with SSI due to MSSA, 2.33 [95% CI, 1.17-4.62]). Lack of independence (ie, poor functional status) remained associated with an increased risk of SSI due to MRSA after stratifying by age.Conclusions.Poor functional status was highly associated with SSI due to MRSA in adult surgical patients, regardless of age. A patient's level of independence can be easily determined, and this information can be used preoperatively to target preventive interventions.

scholarly journals MRSA – ‘Bug-Bear’ of a Surgical Practice: Reducing the Incidence of MRSA Surgical Site Infections

2006 ◽  
Vol 88 (2) ◽  
pp. 222-223 ◽  
Author(s):  
Andrea Guyot ◽  
Graham Layer
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Orthopaedic Surgery ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Surgical Site Infections ◽  
Site Infection ◽  
Infection Rates ◽  
Methicillin Resistant ◽  
Surgical Practice ◽  
Department Of Health

Adverse publicity (the ‘superbug') has demonstrated that the problem of MRSA (methicillin-resistant Staphylococcus aureus) is prevalent in many of the country's most prestigious hospitals. The results of the mandatory UK Department of Health (DH) surveillance for early surgical site infections in orthopaedic surgery (SSIS) have been published recently for the period April 2004 to March 2005 when 41,242 operations were studied (< http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsStatistic > 28 October 2005). Infection rates were generally and gratifyingly low but 48% of surgical site infections were caused by Staph. aureus and of those 68% were MRSA. The following article will discuss the aetiology and prevention of MRSA surgical site infection.

scholarly journals Incidence and risk factors for surgical site infection following elective foot and ankle surgery: a retrospective study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Jinghong Meng ◽  
Yanbin Zhu ◽  
Yansen Li ◽  
Tao Sun ◽  
Fengqi Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Retrospective Study ◽  
Surgical Site Infection ◽  
Elective Surgery ◽  
Site Infection ◽  
Foot And Ankle ◽  
Coagulase Negative Staphylococci ◽  
Methicillin Resistant ◽  
Associated Risk Factors

Abstract Background This study aimed to investigate the incidence of surgical site infection (SSI) in elective foot and ankle surgeries and identify the associated risk factors. Methods This was designed as a retrospective study, including patients who underwent elective surgery of foot and ankle between July 2015 and June 2018. Data on demographics, comorbidities, and perioperative parameters were collected from the medical records, the laboratory report, the operation report, and the outpatient follow-up registration database. SSI was defined in accordance with the Center for Disease Control criteria. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors for SSI. Results A total of 1201 patients undergoing 1259 elective foot/ankle surgeries were included, of whom 26 (2.1%) had an SSI, representing an incidence rate of 1.3% for superficial SSI and 0.8% for deep SSI, respectively. The results for organism culture showed Pseudomonas aeruginosa in 7 cases, methicillin-resistant Staphylococcus aureus (MRSA) in 6, methicillin-susceptible Staphylococcus aureus (MSSA) in 5, methicillin-resistant coagulase-negative Staphylococci (MRCNS) in 2, Escherichia coli in 2, and Proteus mirabilis in 1 case. Five factors were identified to be independently associated with SSI, including prolonged preoperative stay (OR, 1.21; 95% CI, 1.09 to 1.30), allograft or bone substitute (OR, 3.76; 95% CI, 1.51 to 5.30), elevated FBG level (OR, 1.17; 95% CI, 1.04 to 1.26), lower ALB level (OR, 2.33; 95% CI, 1.19 to 3.05), and abnormal NEUT count (OR, 1.72; 95% CI, 1.27 to 2.12). Conclusions SSI following elective foot and ankle surgeries is low, but relatively high in forefoot surgeries, requiring particular attention in clinical practice. Although most not modifiable, these identified factors aid in risk assessment of SSI and accordingly stratifying patients and therefore should be kept in mind.

Importance of Methicillin-Resistant Staphylococcus aureus Eradication in Carriers to Prevent Postoperative Methicillin-Resistant Staphylococcus aureus Surgical Site Infection

2011 ◽  
Vol 77 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Walter E. Pofahl ◽  
Keith M. Ramsey ◽  
Delores L. Nobles ◽  
M. Kathy Cochran ◽  
Claudia Goettler
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Tertiary Care ◽  
Carrier State ◽  
Care Hospital ◽  
Site Infection ◽  
Improvement Project ◽  
Methicillin Resistant ◽  
Rapid Polymerase Chain Reaction

Although infrequent, postoperative methicillin-resistant Staphylococcus aureus (MRSA) surgical site infection (SSI) is associated with significant morbidity and cost. Previous studies have identified the importance of MRSA screening to diminish the risk of postoperative MRSA SSI. The current study quantifies the importance of eradication of the MRSA carrier state to prevent MRSA SSI. Beginning February 2007, all admissions to an 800-bed tertiary care hospital were screened for MRSA by nasal swab using rapid polymerase chain reaction-based testing. Patients found to be nasal carriers of MRSA were treated with 2 per cent mupirocin nasal ointment and 4 per cent chlorhexidine soap before surgery. The subset of patients undergoing procedures that are part of the Surgical Care Improvement Project (SCIP) were followed for MRSA SSI (n = 8980). The results of preoperative MRSA screening and eradication of the carrier state were analyzed. Since the initiation of universal MRSA screening, 11 patients undergoing SCIP procedures have developed MRSA SSI (0.12%). Of these, six patients (55%) had negative preoperative screens. Of the five patients with positive preoperative screens, only one received treatment to eradicate the carrier state. In patients who develop MRSA SSI, failure to treat the carrier state before surgery results in MRSA SSI.

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