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KMID : 1143920190230030265
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Annals of Hepato-Biliary-Pancreatic Surgery
2019 Volume.23 No. 3 p.265 ~ p.273
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Methicillin-resistant Staphylococcus aureus screening is important for surgeons
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Hyun Il-Kwang
Park Pyoung-Jae
Park Da-Won
Choi Sae-Byeol
Han Hyung-Joon
Song Tae-Jin
Jung Cheol-Woong
Kim Wan-Bae
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Abstract
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Backgrounds/Aims: Perioperative surgical site infection (SSI) remains a morbid complication even in successful surgical procedures. We encountered an unusual experience of a methicillin-resistant Staphylococcus aureus (MRSA)-related SSI outbreak in our hospital; therefore, we conducted an epidemiologic analysis to determine the origin of SSIs due to MRSA.
Methods: Among 102 consecutive patients who underwent hepatobiliopancreatic operations, SSIs occurred in eight cases. Infection surveillance regarding the operative environment was carried out. We analyzed the possible risk factors for this infectious outbreak in our institution.
Results: Patients with SSI tended to be older (p=0.293), had variable operation fields (p=0.020), more cancer-related operation (p=0.003), less laparoscopic surgery (p=0.007), performed in operation room 1 (p=0.004), prolonged operation time (p<0.001) and had longer hospital stays (p=0.002). After propensity score (PS) matching, there was the only significant difference in the participation of surgeon D as a second assistant (p=0.001) between the SSI and non-SSI group. After PS matching, surgeon D as a second assistant was the only significant risk factor for MRSA SSI in the univariate (p=0.001) and multivariate analysis (p=0.004, hazard ratio=25.088, 95% confidence interval=2.759-228.149).
Conclusions: Outbreak of SSIs occurred due to transmission of MRSA from a surgeon to patients despite the standard regulation of infection control. These SSIs were associated with an excessive incidence of surgeon’s nasal and hand carriage of the MRSA strain identified in the surgeon via cultures. We recommend the preoperative regular nasal and hand screening for MRSA among surgeons.
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KEYWORD
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Surgical site infection, Methicillin-resistant Staphylococcus aureus, Screening
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