Evaluating the role of methicillin-resistant Staphylococcus aureus (MRSA)-specific antibiotic prophylaxis for neurosurgical patients

Adapa, Arjun; Linzey, Joseph R; Daou, Badih; Mehta, Unnati; Patel, Twisha S; Ponnaluri-Wears, Sreelatha; Washer, Laraine; Thompson, B. Gregory; Park, Paul; Pandey, Aditya S.

doi:10.1016/j.clineuro.2020.106353

Cited by 3 publications

(9 citation statements)

References 32 publications

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“…Following an assessment of 509 relevant papers, 14 studies that were released between 2014 and 2022 were included in the meta‐analysis since they matched the inclusion criteria 8–21,34–49 . Table 2 summarizes the findings of these investigations.…”

Section: Resultsmentioning

confidence: 99%

“…The sample size was 247-356 people. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] The examined data revealed that MRSA-positive had a significantly higher SSI compared with MRSA-negative in SS subjects.…”

Section: Discussionmentioning

confidence: 99%

“…For the current meta‐analysis, 14 exams from 2014 to 2022 were included; of these, 18 410 people were tested for nasal colonization after SS. The sample size was 247–356 people 8–21,34–49 . The examined data revealed that MRSA‐positive had a significantly higher SSI compared with MRSA‐negative in SS subjects.…”

Section: Discussionmentioning

confidence: 99%

“… 7 Nevertheless, contradictory results have been found in pilot investigations examining the function of Staphylococcus aureus nasal colonization in individuals who have had spine procedures. 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 While some preliminary research has demonstrated that nasal methicillin‐resistant Staphylococcus aureus (MRSA) colonization may be predictive of SSI following spine surgeries, 8 , 9 , 13 other studies have not found a link between SSI risk and nasal MRSA colonization in these patients. 10 , 11 , 12 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 It is likely that the small patient populations in these pilot studies—particularly those involving nasal MRSA colonization—mean that the restricted research scales will not be statistically sufficient to yield meaningful findings.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of surgical site wound infection after spine surgery in nasal colonization of methicillin‐resistant Staphylococcus aureus: A meta‐analysis

Imam,

Abdel‐Sattar,

Alqarni

et al. 2023

International Wound Journal

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The purpose of the meta‐analysis was to evaluate and compare the prevalence of surgical site infection (SSI) after spine surgery (SS) in nasal colonization of methicillin‐resistant Staphylococcus aureus (MRSA). The results of this meta‐analysis were analysed, and the odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated using dichotomous or contentious random‐ or fixed‐effect models. For the current meta‐analysis, 14 examinations spanning from 2014 to 2022 were included, encompassing 18 410 people who were tested for nasal colonization after SS. MRSA‐positive had a significantly higher SSI (OR, 3.65; 95% CI, 2.48–5.37, p < 0.001) compared with MRSA‐negative in SS subjects. However, no significant difference was found between methicillin‐susceptible Staphylococcus aureus and Staphylococcus aureus negative (OR, 0.94; 95% CI, 0.32–2.79, p = 0.91), and Staphylococcus aureus positive and negative (OR, 2.13; 95% CI, 0.26–17.41, p = 0.48) in SS subjects. The examined data revealed that MRSA colonization had a significant effect on SSI; however, methicillin‐susceptible Staphylococcus aureus and Staphylococcus aureus had no significant effect on SSI in SS subjects. However, given that some comparisons included a small number of chosen studies, attention should be given to their values.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of surgical site wound infection after spine surgery in nasal colonization of methicillin‐resistant Staphylococcus aureus: A meta‐analysis

Imam,

Abdel‐Sattar,

Alqarni

et al. 2023

International Wound Journal

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“…Generally, vancomycin is the preferred antibiotic for patients with methicillin-resistant Staphylococcus aureus colonization, frequently seen in high-risk patients in health care settings. Using lower than recommended vancomycin doses may be especially deleterious owing to the potentially increased risk of SSIs in these patients . Moreover, nonadherence to guideline-based vancomycin administration has been linked to an increased rate of SSIs .…”

Section: Discussionmentioning

confidence: 99%

Adherence to Guidelines for the Administration of Intraoperative Antibiotics in a Nationwide US Sample

Bardia

Michel

Dai³

et al. 2021

JAMA Netw Open

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IMPORTANCEDespite widespread adherence to Surgical Care Improvement Project antibiotic measures, prevention of surgical site infections (SSIs) remains a clinical challenge. Several components of perioperative antibiotic prophylaxis guidelines are incompletely monitored and reported within the Surgical Care Improvement Project program. OBJECTIVES To describe adherence to each component of perioperative antibiotic prophylaxis guidelines in regard to procedure-specific antibiotic choice, weight-adjusted dosing, and timing of first and subsequent administrations in a nationwide, multicenter cohort of patients undergoing noncardiac surgery. DESIGN, SETTING, AND PARTICIPANTS This cohort study included adult patients undergoing general, urological, orthopedic, and gynecological surgical procedures involving skin incision between January 1, 2014, and December 31, 2018, across 31 academic and community hospitals identified within the Multicenter Perioperative Outcomes Group registry. Data were analyzed between April 2 and April 21, 2021. MAIN OUTCOMES AND MEASURES The primary end point was overall adherence to InfectiousDiseases Society of America guidelines, including (1) appropriateness of antibiotic choice, (2) weightbased dose adjustment, (3) timing of administration with respect to surgical incision, and (4) timing of redosing when indicated. Data were analyzed using mixed-effects regression to investigate patient, clinician, and institutional factors associated with guideline adherence. RESULTSIn the final cohort of 414 851 encounters across 31 institutions, 51.8% of patients were women, the mean (SD) age was 57.5 (15.7) years, 1.2% of patients were of Hispanic ethnicity, and 10.2% were Black. In this cohort, 148 804 encounters (35.9%) did not adhere to guidelines: 19.7% for antibiotic choice, 17.1% for weight-adjusted dosing, 0.6% for timing of first dose, and 26.8% for redosing. In adjusted analyses, overall nonadherence was associated with emergency surgery (odds

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European Society of Clinical Microbiology and Infectious Diseases/European Committee on infection control clinical guidelines on pre-operative decolonization and targeted prophylaxis in patients colonized by multidrug-resistant Gram-positive bacteria before surgery

Righi,

Mutters,

Guirao

et al. 2024

Clinical Microbiology and Infection

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Evaluating the role of methicillin-resistant Staphylococcus aureus (MRSA)-specific antibiotic prophylaxis for neurosurgical patients

Cited by 3 publications

References 32 publications

Prevalence of surgical site wound infection after spine surgery in nasal colonization of methicillin‐resistant Staphylococcus aureus: A meta‐analysis

Prevalence of surgical site wound infection after spine surgery in nasal colonization of methicillin‐resistant Staphylococcus aureus: A meta‐analysis

Adherence to Guidelines for the Administration of Intraoperative Antibiotics in a Nationwide US Sample

European Society of Clinical Microbiology and Infectious Diseases/European Committee on infection control clinical guidelines on pre-operative decolonization and targeted prophylaxis in patients colonized by multidrug-resistant Gram-positive bacteria before surgery

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