INCIDENCE AND OUTCOME OF NASAL AND GROIN METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS CARRIER STATE IN PATIENTS ADMITTED FOR ROUTINE CARDIAC SURGERY

Abstract

Objective: To find out the incidence of nasal and groin Methicillin-resistant Staphylococcus aureus

(MRSA) carrier status in patients undergoing routine cardiac surgery and to study its effect on postoperative

wound infections with MRSA.

Material and Methods: Patients undergoing routine cardiac surgery between 30-04-2007 and 31-10-

2007 at Rehman Medical Institute, Peshawar were enrolled in the study. Nasal and groin swabs were taken

on admission to check for MRSA carriage. Patients requiring emergency surgery were not included in the

study. Swabs for culture and sensitivity were taken from patients with post-operative surgical wound

discharge. The post-operative wound infections were compared in the MRSA carrier (carrier group) and

non-carrier (control group) groups.

Results: Out of 333 (297 open-heart and 36 close-heart) patients undergoing routine cardiac surgery

during this period, 52 (18 %) open and 2 (6 %) close heart patients had either nasal or groin or both

swabs positive for MRSA. Two patients developed post-operative mediastinitis; one of them was with MRSA

from the control group. The patient with mediastinitis with organisms other than MRSA was excluded from

study. Two other open-heart patients, one from each group, developed superficial sternotomy wound

infection with MRSA. The difference in the incidence of post-operative wound infections with MRSA in the

two groups was not significant statistically. All patients who developed surgical site infection with MRSA

were diabetic.

Conclusion: Pre-operative MRSA carriers, undergoing elective cardiac surgery, did not have a

statistically significant higher incidence of post-operative MRSA wound infections.