Nasal carriage of staphylococci and post-operative staphylococcal wound infection

Abstract

One hundred patients undergoing major surgical operations in a provincial group hospital were studied bacteriologically daily to determine any relation between nasal carriage of staphylococci and post-operative staphylococcal wound sepsis.Sixty-four patients were either carriers on admission and throughout their stay, or their noses became colonized at some time by ward strains. Six cases of staphylococcal wound or drain wound sepsis occurred in this group, four due to ward strains and two to the patient's own nasal strain. Four patients lost the nasal strain after admission and thereafter their noses remained free from staphylococci. There was no sepsis among these. Thirty-two patients never carried staphylococci in their noses at any time. There was no wound sepsis in this group but in two patients the drain wounds became infected with ward strains. Grouping all cases of staphylococcal wound or drain wound sepsis there were three times as many caused by ward strains as by nasal strains. In 10 of the 11 cases of wound or drain wound sepsis, including three cases due to Gram-negative bacteria, a physical cause in the shape of a drain, necrosis of skin edges, or loss of tissue was present, providing an entry for bacteria.