Editorial| Volume 134, ISSUE 5, SUPPLEMENT , S1, November 2003

Surgical site infections: A cause for concern

      Nosocomial infections are infections that develop as a result of medical or surgical care and affect approximately 5% of hospitalized patients. An astonishing 70% of these infections are caused by antibiotic-resistant pathogens. Surgical-site infections account for more than 30% of nosocomial infections, which represents a major risk for the nearly 42 million patients who undergo surgery each year. Staphylococcus aureus is one of the principal causes of surgical site infections and accounts for nearly 30% of these nosocomial infections. Data have shown that patients with nasal colonization of S aureus are at an increased risk for postoperative surgical site infection compared with patients who are not colonized. Mupirocin, a topical antibiotic, can eradicate S aureus from the nasopharynx successfully when administered intranasally, which reduces the risk of surgical site infections. There is considerable debate regarding the ideal candidate for intranasal mupirocin: all surgical patients or only those patients who have test results that are positive for S aureus carriage before surgery. A significant disadvantage to this latter approach is that culture results may take 1 to 2 days or longer to obtain, a length of time that is not practical for patients who undergo same-day surgery.
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