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Surgical site infections: A cause for concern
Surgical site infections: A cause for concern Michael K. Banbury MD, Cleveland, Ohio
NOSOCOMIAL INFECTIONS ARE INFECTIONS that develop as a result of medical or surgical care and affect approximately 5% of hospitalized patients. An astonishing 70% of these infections are caused by antibiotic-resistant pathogens. Surgical-site infections account for more than 30% of nosocomial infections, which represents a major risk for the nearly 42 million patients who undergo surgery each year. Staphylococcus aureus is one of the principal causes of surgical site infections and accounts for nearly 30% of these nosocomial infections. Data have shown that patients with nasal colonization of S aureus are at an increased risk for postoperative surgical site infection compared with patients who are not colonized. Mupirocin, a topical antibiotic, can eradicate S aureus from the nasopharynx successfully when administered intranasally, which
reduces the risk of surgical site infections. There is considerable debate regarding the ideal candidate for intranasal mupirocin: all surgical patients or only those patients who have test results that are positive for S aureus carriage before surgery. A significant disadvantage to this latter approach is that culture results may take 1 to 2 days or longer to obtain, a length of time that is not practical for patients who undergo same-day surgery. The supplement will highlight strategies for the decolonization of S aureus, evaluate recent study data that demonstrate the beneficial effects of the perioperative use of intranasal mupirocin to prevent postoperative S aureus infection, and review the experience with decolonization of S aureus in prevention of sternal wound infections in nasal carriers.
Sponsored by the Office of Continuing Medical Education at Excerpta Medica and supported by an educational grant from GlaxoSmithKline. Surgery 2003;134:S1. Ó 2003, Mosby, Inc. All rights reserved. 0039-6060/03/$30.00 + 0 doi:10.1016/S0039-6060(03)00388-X
SURGERY S1
NOSOCOMIAL INFECTIONS ARE INFECTIONS that develop as a result of medical or surgical care and affect approximately 5% of hospitalized patients. An astonishing 70% of these infections are caused by antibiotic-resistant pathogens. Surgical-site infections account for more than 30% of nosocomial infections, which represents a major risk for the nearly 42 million patients who undergo surgery each year. Staphylococcus aureus is one of the principal causes of surgical site infections and accounts for nearly 30% of these nosocomial infections. Data have shown that patients with nasal colonization of S aureus are at an increased risk for postoperative surgical site infection compared with patients who are not colonized. Mupirocin, a topical antibiotic, can eradicate S aureus from the nasopharynx successfully when administered intranasally, which
reduces the risk of surgical site infections. There is considerable debate regarding the ideal candidate for intranasal mupirocin: all surgical patients or only those patients who have test results that are positive for S aureus carriage before surgery. A significant disadvantage to this latter approach is that culture results may take 1 to 2 days or longer to obtain, a length of time that is not practical for patients who undergo same-day surgery. The supplement will highlight strategies for the decolonization of S aureus, evaluate recent study data that demonstrate the beneficial effects of the perioperative use of intranasal mupirocin to prevent postoperative S aureus infection, and review the experience with decolonization of S aureus in prevention of sternal wound infections in nasal carriers.
Sponsored by the Office of Continuing Medical Education at Excerpta Medica and supported by an educational grant from GlaxoSmithKline. Surgery 2003;134:S1. Ó 2003, Mosby, Inc. All rights reserved. 0039-6060/03/$30.00 + 0 doi:10.1016/S0039-6060(03)00388-X
SURGERY S1