Efficacy of Pre-Operative MRSA Screening in Otolaryngology

Abstract

Objective To examine the efficacy of pre-operative Staphylococcus aureus screening by nasal swab on post-operative Methicillin-resistant Staphylococcus aureus (MRSA) infection rates in surgical patients undergoing varied otolaryngological procedures. Methods Retrospective review of MRSA colonization and infection rates in surgical otolaryngology patients at a single institution. MRSA infection rates in unscreened patients undergoing procedures during a one-year period were compared to infection rates in patients undergoing pre-operative Staphylococcus aureus screening in an 11-month time frame. Patients colonized with Staphylococcus aureus were treated with Mupirocin and Chlorhexidine prior to the procedure. Results Records of 420 patients undergoing varied otolaryngological procedures were evaluated. In the 241 patients without pre-operative screening, 9 patients had Staphylococcus aureus-infected wounds. There were two (0.83%) post-operative MRSA surgical site infections. Out of 179 patients followed after screening was initiated, 24 patients (13.4%) were colonized with Staphylococcus aureus and underwent preoperative treatment. There were no MRSA infections in the post-operative period. Conclusions Early results demonstrate the potential benefit of pre-operative Staphylococcus aureus screening in reducing the MRSA infection rate. Screening and treatment of MRSA colonized patients pre-operatively reduces infectious complications and should be considered in otolaryngology surgical practice.