Update: Methicillin-Resistant Staphylococcus aureus Screening and Decolonization in Cardiac Surgery

Risk factors for, and the effect of MRSA colonization on the clinical outcomes of severely burnt patients

“…Thus, we did not differentiate between these potentially confounded variables and also limited our outcome analysis to factors with unequivocal definitions. Further, it is of note, that in other surgical specialties uniform reports exist, which have shown that specifically in the context of MRSA positive screening swabs (=''colonization'') are associated with a substantially elevated risk for surgical site infections [29][30][31][34][35][36]. This association is further underscored by our data, which shows b u r n s x x x ( 2 0 1 5 ) x x x -x x x that 81% of our MRSA positive patients had positive nose/groin swabs and 75% of MRSA positive patients also had positive isolates from their wound cultures.…”

Update on screening and clinical diagnosis of meticillin-resistant Staphylococcus aureus (MRSA)

“…Existing guidelines do not make any specific recommendation regarding the preferred method to perform screening [35]. The choice of screening method for MRSA will also be influenced by the type of institution, laboratory infrastructure, expertise of personnel, and resources available to the laboratory.…”

“…Thus, in addition to whether screening should be universal or targeted, the choice and number of body sites to be screened needs to be considered. Limiting screening efforts to only the nares is often directed more by resources and budgets than by science [35]. Most European experts agree that screening only the nares lacks sensitivity if the goal is to detect all MRSA-colonised patients.…”

“…Real-time quantitative polymerase chain reaction assays can be performed rapidly, with results available in ≤2 h [46]. The sensitivity of commercial PCR assays ranges from 68% to 100% and the specificity from 64% to 99% (Table 3) [35,48,49]. Stüren-burg [3] provides a useful summary of the current commercially available rapid tests, including PCR-based methods and culture techniques.…”

Strategic choices to reduce implantable cardioverter-defibrillator-related morbidity

“…Although not proven in the literature on ICD use, several studies of patients undergoing cardiac surgery have shown that treatment of carriers of MRSA with mupirocin decreases the rate of postoperative infection. [21][22][23] Patients are not currently recommended to routinely receive antibiotic therapy after device implantation.…”