Background
Patients colonized with methicillin-resistant Staphylococcus aureus (MRSA) are at increased risk for invasive infection compared with noncolonized patients;
however, the magnitude of risk for MRSA surgical site infection (SSI) is unclear.
To aid in planning of infection prevention strategies, we sought to assess the incidence
of MRSA SSI in MRSA carriers.
Methods
We conducted a retrospective cohort study at our tertiary care center of inpatients
who underwent MRSA polymerase chain reaction (PCR) screen of the nares within 30 days
before a National Healthcare Safety Network principal procedure between April 2008
and July 2010.
Results
The rate of MRSA SSI was 1.86% in the MRSA PCR-positive group (n = 431) and 0.20%
in the MRSA PCR-negative group (n = 9432). Multivariate analysis identified MRSA PCR-positive
status as an independent risk factor for MRSA SSI (odds ratio, 9.20; 95% confidence
interval, 3.81-20.47; P < .0001); other risk factors included duration of surgery ≥137 minutes, American
Society of Anesthesiologists score ≥3, and abdominal surgery.
Conclusions
Surgical patients with a positive nasal MRSA PCR screen had a 9-fold greater odds
of developing a subsequent MRSA SSI compared with patients with a negative nasal MRSA
PCR screen. The incidence of MRSA SSI in PCR-positive patients was low (1.86%), however,
and identifying subsets of patients at greatest risk for SSI may help target decolonization
and other interventions.
Key Words
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Article info
Publication history
Published online: August 23, 2013
Footnotes
Conflict of interest: None to report.
Identification
Copyright
© 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
