Preoperative screening for nasal carriage of methicillin-resistant Staphylococcus aureus in patients undergoing general thoracic surgery

Yoshimasa Mizuno; Koyo Shirahashi; Hirotaka Yamamoto; Mitsuyoshi Matsumoto; Yusaku Miyamoto; Hiroyasu Komuro; Kiyoshi Doi; Hisashi Iwata

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Preoperative screening for nasal carriage of methicillin-resistant Staphylococcus aureus in patients undergoing general thoracic surgery

VernacularTitle:Preoperative screening for nasal carriage of methicillin-resistant Staphylococcus aureus in patients undergoing general thoracic surgery
Author: Yoshimasa MIZUNO ¹ ; Koyo SHIRAHASHI ² ; Hirotaka YAMAMOTO ² ; Mitsuyoshi MATSUMOTO ² ; Yusaku MIYAMOTO ² ; Hiroyasu KOMURO ² ; Kiyoshi DOI ² ; Hisashi IWATA ³
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1. Department of General Thoracic Surgery, Chuno Kosei Hospital, Japan
2. Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, Japan
3. Department of General Thoracic Surgery, Center of Respiratory Disease, Gifu University Hospital, Japan
Keywords: methicillin-resistant Staphylococcus aureus; preoperative screening; surgical site infection
From:Journal of Rural Medicine 2019;14(1):73-77
CountryJapan
Language:English
Abstract: Objectives: Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for surgical site infections (SSIs). However, few studies have evaluated the rate of nasal carriage of MRSA and its effect on SSIs in patients undergoing general thoracic surgery. We investigated the importance of preoperative screening for nasal carriage of MRSA in patients undergoing general thoracic surgery.Patients and Methods: We retrospectively analyzed 238 patients with thoracic diseases who underwent thoracic surgery. We reviewed the rates of nasal carriage of MRSA and SSIs.Results: Results of MRSA screening were positive in 11 of 238 patients (4.6%), and 9 of these 11 patients received nasal mupirocin. SSIs occurred in 4 patients (1.8%). All 4 patients developed pneumonia; however, MRSA pneumonia occurred in only 1 of these 4 patients. No patient developed wound infection, empyema, and/or mediastinitis. SSIs did not occur in any of the 11 patients with positive results on MRSA screening.Conclusions: The rates of nasal carriage of MRSA and SSIs were low in this case series. Surveillance is important to determine the prevalence of MRSA carriage and infection in hospitals, particularly in the intensive care unit. However, routine preoperative screening for nasal carriage of MRSA is not recommended in patients undergoing general thoracic surgery.