Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for large numbers of postsurgical nosocomial infections across the United States and worldwide. Propofol anesthesia is widely used in surgery and in intensive care units, and recent evidence indicates that even brief exposure to propofol can substantially increase host susceptibility to microbial infection. Here, we delineate the impact of propofol sedation on MRSA bloodstream infections in mice in the presence and absence of prophylactic antibiotic treatment. Consistent with previous reports, brief periods of anesthesia with propofol were sufficient to significantly increase bacterial burdens and kidney pathology in mice infected with MRSA. Propofol exposure increased neutrophilic infiltrates into the kidney and enhanced bacterial dissemination throughout kidney tissue. Propofol sedation reduced populations of effector phagocytes and mature dendritic cells within the kidney and led to the apparent expansion of myeloid-derived suppressor cell-like populations. When propofol was coadministered with vancomycin prophylaxis, it dramatically increased kidney abscess formation and bacterial dissemination throughout kidney tissue at early times post-S. aureus infection compared to antibiotic-treated but nonsedated animals. Taken together, our data indicate that short-term sedation with propofol significantly increases the severity of bloodstream MRSA infection, even when administered in conjunction with vancomycin prophylaxis.KEYWORDS MRSA, anesthesia, bacterial pathogenesis, immune suppression, kidney abscess, macrophages, monocytes, vancomycin N osocomial infections are common complications that follow surgery or prolonged stays in intensive care units (ICU) of hospitals (1-5) and which result in large increases in patient morbidity and mortality in addition to elevated health care costs (6). The causative agents of nosocomial infection are often bacteria (4, 7), and Staphylococcus aureus is one of the most frequently isolated pathogens in this regard (8). Antibiotic treatment of S. aureus infections can be complicated by the prevalence of methicillin-resistant S. aureus (MRSA) strains in hospitals and increasingly in community settings (9, 10). Patients often require multiple antibiotics or use of broad-spectrum antibiotics to eradicate infection (11). Despite numerous measures taken to ensure sterility and limit spread of MRSA from health care workers to patients in hospitals (12, 13), the rate of infection remains high (14,15). While significant effort is generally focused on enforcing aseptic technique as a method to prevent infection, there may be additional factors that influence the frequency and/or severity of nosocomial infections (16).Propofol is one of the most common anesthetic agents used in the induction and maintenance of anesthesia prior to surgery, both in the intensive care unit (ICU) and in routine outpatient procedures (17)(18)(19)(20). This is in part due to its low incidence of anesthesia-related side effects and the shor...