Alexander O'Dell Impact of Staphylococcus Aureus Nasal Colonization on Outcomes Following Elective General Thoracic Surgery
SchoolBrecksville-Broadview Heights High School
MentorSudish Murthy, MD, PhD
DepartmentThoracic and Cardiovascular Surgery
Impact of Staphylococcus Aureus Nasal Colonization on Outcomes Following Elective General Thoracic Surgery
From January 1, 2009, to June 1, 2009, patients undergoing general thoracic surgery and requiring ICU admission were screened for nasal Staphylococcus Aureus (SA) carriage. Surveillance was linked to an eradication protocol. We attempted to correlate SA carriage (both methicillin-sensitive [MSSA] and resistant [MRSA]) with clinical outcome after surgery.
For the 181 patients who were included, demography, type of operation, smoking history and presence of diabetes mellitus (DM) were gathered. Outcomes included length of stay and presence of any postoperative infectious complications. Nasal carriage rate of SA was 30.1% (55 patients). There were 18 MRSA (10%) and 37 (20.1%) MSSA carriers and 42% of these patients were treated with mupirocin. Postoperative infectious complications were found in 34.5% of SA positive patients and 17.5% of non-carriers (p=.06). Specifically, of 11 SA-related postoperative infections, eight were SA carriers, and surprisingly, three had received mupirocin prophylaxis. A history of DM appeared to select out SA carriage, as its presence was associated with a 2.5 times greater risk of nasal SA (p=.02).
A surprisingly high rate of SA carriage is found in patients undergoing general thoracic surgery. Mupirocin prophylaxis may not alter risk of subsequent SA infection. DM appears to be a risk for SA carriage in this cohort of patients.