INCIDENCE AND OUTCOME OF NASAL AND GROIN METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS CARRIER STATE IN PATIENTS ADMITTED FOR ROUTINE CARDIAC SURGERY

Objective: To find out the incidence of nasal and groin Methicillin-resistant Staphylococcus aureus (MRSA) carrier status in patients undergoing routine cardiac surgery and to study its effect on postoperative wound infections with MRSA Material and Methods: Patients undergoing routine cardiac surgery between 30-04-2007 and 31-102007 at Rehman Medical Institute, Peshawar were enrolled in the study. Nasal and groin swabs were taken on admission to check for MRSA carriage. Patients requiring emergency surgery were not included in the study. Swabs for culture and sensitivity were taken from patients with post-operative surgical wound discharge. The post-operative wound infections were compared in the MRSA carrier (carrier group) and non-carrier (control group) groups. Results: Out of 333 (297 open-heart and 36 close-heart) patients undergoing routine cardiac surgery during this period, 52 (18 %%) open and 2 (6 %%) close heart patients had either nasal or groin or both swabs positive for MRSA. Two patients developed post-operative mediastinitis; one of them was with MRSA from the control group. The patient with mediastinitis with organisms other than MRSA was excluded from study. Two other open-heart patients, one from each group, developed superficial sternotomy wound infection with MRSA The difference in the incidence of post-operative wound infections with MRSA in the two groups was not significant statistically. All patients who developed surgical site infection with MRSA were diabetic. Conclusion: Pre-operative MRSA carriers, undergoing elective cardiac surgery did not have a statistically significant higher incidence of post-operative MRSA wound infections.