The benefits of using rapid molecular diagnostic technology for pre-operative screening of MRSA/S. aureus carriers are highlighted by an international group of infection control experts in a recent consensus paper.

Surgical site infections (SSIs) are among the most common healthcare-associated infections (HAIs), and result in significant morbidity and mortality.  Nasal colonization with S. aureus is the most important independent risk factor for the development of an SSI in clean surgery, as the rate is 2 to 9 times higher in carriers than in non-carriers.

Following the 1st European S. aureus & Surgical Site Infection round table, 10 European and American experts reviewed the evidence on the value of screening for nasal carriage of S. aureus and subsequent decolonization of positive patients pre-operatively. Their findings were published as a consensus paper in the Journal of Hospital Infection.

SSI Additional Length of Stay and Cost

There is a clear correlation between empirical/universal use of mupirocin and antiseptic and the emergence of resistance to these agents amongst MSSA, MRSA and S. epidermidis, increasing from 60 to 95%.

An efficient solution for patients undergoing clean surgery is the utilization of rapid molecular diagnostic technology for the pre-operative identification of carriers of MSSA and MRSA, followed by mupirocin and chlorhexidine decolonization.

This treatment strategy is associated with reduced SSI rates and cost savings:

• Reduced the rate of S. aureus infection by 60%
• Decreased the mortality rate by 57%
• Reduced hospital LOS by 2 days
• Reduced cost of care by 2 841 € (3,044 USD) per cardiothoracic patient and 955 € (1,023 USD) per orthopedic patient

Screening and selective decolonization of patients positive for S. aureus have the benefits of preventing SSIs, helping to contain costs, monitoring changes in circulating isolates of MSSA and MRSA, and minimizing the emergence of resistance.”

Reference:
H. Humphreys et al. Journal of Hospital Infection 2016