Prevalence of Staphylococcus aureus nasal carriage and surgical site infection rate among patients undergoing elective cardiac surgery

Abstract

Background: Nasal carriers of Staphylococcus aureus are at increased risk of postoperative surgical site infection. Nasal decolonization with mupirocin is recommended in patients undergoing cardiac surgery to reduce surgical site infection. These data are still lacking in Thailand. Therefore, the aim of this study was to determine the prevalence of S. aureus nasal carriage in Thai patients undergoing elective cardiac surgery. The association of surgical site infection and S. aureus nasal carriage was also examined. Methods: This was a prospective cohort study of 352 patients who planned to undergo elective cardiac surgery. Nasal swab culture was performed in all patients preoperatively. Results: Of 352 patients, 46 (13.1%) had a positive nasal swab culture for methicillin-sensitive S. aureus (MSSA) and one patient (0.3%) harbored a methicillin-resistant S. aureus (MRSA) strain. The incidence of superficial and deep surgical site infection was 1.3% and 0.3%, respectively. After multivariate analysis, S. aureus nasal carriage was independently associated with superficial surgical site infection (odds ratio 13.04, 95% confidence interval 1.28-133.27; P = 0.03). Conclusions: The prevalence of MSSA and MRSA nasal carriage in Thai patients undergoing elective cardiac surgery was low. The incidence of surgical site infection was also very low in the population studied. Nevertheless, it was found that S. aureus nasal carriage increased the risk of superficial surgical site infection.

Staphylococcus aureus nasal carriage and bloodstream infection among conventional hemodialysis patients in Thailand: a prospective multicenter cohort study

“…Although this study was conducted in tertiary hospital hemodialysis centers, we did not find MRSA. This conforms with reported data in Thailand which indicated an extremely low rate of MRSA nasal colonization either among patients or healthcare personnel [ 13 , 14 , 17 ]. The molecular basis and biofilm-forming capacity of S. aureus in each strain play a major role in the ability to colonize and develop invasive diseases [ 2 , 26 – 28 ].…”

“…Firstly, the prevalence of S. aureus nasal carriage in the general population in Thailand is low. Related studies in Thailand reported the prevalence of S. aureus nasal carriage at 20, 13.9, and 3.6% among patients with allergic rhinitis, patients undergoing elective cardiac surgery, and pre-admission screening, respectively [ 12 – 14 ]. These proportions are lower than the reported prevalence in the US and Germany at 22% and 40%, respectively [ 4 , 15 ].…”

Staphylococcus aureus Nasal Carriage and Blood Stream Infection among Conventional Hemodialysis Patients in Thailand: a Prospective Multicenter Cohort Study

“…Although this study was conducted in tertiary hospital hemodialysis centers, we could not nd MRSA. This conforms with the related data in Thailand which indicated an extremely low rate of MRSA nasal colonization either among patients or healthcare personnel [13,14,17]. The molecular basis of S. aureus in each strain plays a major role in the ability of colonization and developing invasive diseases [2].…”

“…Firstly, the prevalence of S. aureus nasal carriage in the general population in Thailand is low. Related studies in Thailand reported prevalence of S. aureus nasal carriage at 20, 13.9, and 3.6% among patients with allergic rhinitis, patients undergoing elective cardiac surgery, and pre-admission screening, respectively [12][13][14]. These proportions are fewer than the reported prevalence in the US and Germany at 22% and 40%, respectively [4,15].…”