Abstract
The current literature indicates that surgical-site infections significantly increase
costs and length of stay. Nosocomial infections that are acquired after operative
procedures increase mortality rates. Staphylococcus aureus is a major cause of surgical-site infections among patients, particularly patients
who undergo cardiothoracic surgery. Patients who carry S aureus in their nares are at increased risk for surgical-site infections that are caused
by this organism. Occasionally, health care workers who carry S aureus in their nares can cause outbreaks of surgical-site infections or other nosocomial
infections. Persons who carry S aureus in their nares and have upper respiratory tract infections may spread this organism
to numerous staff members and patients. Key measures for decreasing rates of these
and other nosocomial infections include the appropriate use of prophylactic antimicrobial
agents, surveillance and reporting of infections, and surveillance for clusters of
infection caused by the same strain of S aureus and culture and surveys, when appropriate, to help identify infected health care
workers. Additionally, surgical masks may prevent health care workers from inadvertent
transmission of S aureus from their nares to patients' surgical sites.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Memories and tributes of relatives, colleagues and students, with some autobiographical writings.The Aberdeen University Press, Aberdeen, Scotland1943
- A century of surgery: the history of the American Surgical Association.Lippincott, Philadelphia1981
- Micro-organisms in surgical diseases.BMJ. 1881; 1: 369-375
- Pathogenic staphylococci from anterior nares: incidence and differentiation.Proc Soc Exp Biol Med. 1937; 36: 789-794
- Operation room infections.Arch Surg. 1937; 34: 874-896
- Determinants of hospital charges for coronary artery bypass surgery: the economic consequences of postoperative complications.Am J Cardiol. 1990; 65: 309-313
- Determinants of prolonged length of hospital stay after coronary bypass surgery.Circulation. 1989; 80: 276-284
- Cost of surgical site infections following coronary artery bypass surgery.Aust N Z J Surg. 2001; 71: 662-664
- The clinical and economic impact of deep chest surgical site infections following coronary artery bypass graft surgery.Chest. 2000; 118: 397-402
- Leg wound complications associated with coronary revascularization.J Thorac Cardiovasc Surg. 1981; 81: 403-407
- Surveillance of surgical wound infections following open heart surgery.Infect Control Hosp Epidemiol. 1991; 12: 591-596
- The epidemiology of saphenous vein harvest site wound infections after cardiothoracic surgery.([abstract])Proceedings of the 3rd Annual Meeting of the Society for Healthcare Epidemiology of America; 1993 April 18–20; Chicago, Illinois. Society for Healthcare Epidemiology, Inc, West Deptford, NJ1993 (p. A28)
- The impact of nosocomial infections on patient outcomes following cardiac surgery.Chest. 1997; 112: 666-675
- Methicillin-resistant Staphylococcus aureus infection in a cardiac surgical unit.J Thorac Cardiovasc Surg. 2002; 123: 40-44
- The economic implications of infection in cardiac surgery.Ann Thorac Surg. 1986; 42: 240-246
- Carriage of Staphylococcus aureus: epidemiology and clinical relevance.J Lab Clin Med. 1999; 133: 525-534
- Staphylococcus aureus nasal carriage in patients with rhinosinusitis.Laryngoscope. 1991; 101: 733-737
- Staphylococcal skin colonization in children with atopic dermatitis: prevalence, persistence, and transmission of toxigenic and nontoxigenic strains.J Infect Dis. 1992; 165: 1064-1068
- Epidemiology and treatment of chronic staphylococcal infections in the household.Am J Public Health. 1962; 52: 1828-1843
- Staphylococcus aureus among insulin-injecting diabetic patients: an increased carrier rate.JAMA. 1975; 231: 1272
- NIDDM and prevalence of nasal colonization: San Luis Valley Diabetes Study.Diabetes Care. 1989; 12: 189-192
- Staphylococcus aureus carriage rate of patients receiving long-term hemodialysis.Arch Intern Med. 1978; 138: 1657-1659
- Reduction of Staphylococcus aureus nasal carriage and infection in dialysis patients.J Hosp Infect. 1998; 40: S13-S23
- Risk factors for nasal carriage of Staphylococcus aureus in infectious disease patients, including patients infected with HIV, and molecular typing of colonizing strains.Eur J Clin Microbiol Infect Dis. 2002; 21: 88-96
- Intranasal mupirocin to prevent post-operative Staphylococcus aureus infections.N Engl J Med. 2002; 46: 1871-1877
Herwaldt LA, Cullen J, Hu J, Wenzel RP, Perl TM. Risk factors for Staphylococcus aureus nasal carriage among surgical patients. Presented at the 13th Annual Meeting of the Society for Healthcare Epidemiology of America; April 5-8, 2003; Arlington, Virginia.
- Experience in prevention of sternal wound infections in nasal carriers of Staphylococcus aureus.Surgery. 2003; 134: S18-S22
- Nasal reservoir as the source of extranasal staphylococci.Antimicrob Agents Chemother. 1963; 3: 679-683
- Increased infection rates in heavy nasal carriers of coagulase-positive staphylococci.Antimicrob Agents Chemother. 1963; 3: 667-670
- Elimination of coincident Staphylococcus aureus nasal and hand carriage with intranasal application of mupirocin calcium ointment.Ann Intern Med. 1991; 114: 101-106
- The significance of nasal carriage of Staphylococcus aureus and the incidence of postoperative wound infection.J Hosp Infect. 1995; 31: 13-24
- Nasal carriage of Staphylococcus aureus is a major risk factor for surgical-site infections in orthopedic surgery.Infect Control Hosp Epidemiol. 2000; 21: 319-323
- Nasal carriage of Staphylococcus aureus as a major risk factor for wound infections after cardiac surgery.J Infect Dis. 1995; 171: 216-219
- Sternal wound infection after heart operations in pediatric patients associated with nasal carriage of Staphylococcus aureus.J Thorac Cardiovasc Surg. 1996; 112: 681-686
- The virulence of Staphylococcus pyogenes for man: a study of the problems of wound infection.Br J Exp Pathol. 1957; 38: 573-586
- Control of Staphylococcus aureus in an operating theatre.Lancet. 1939; : 1088-1094
- An outbreak of Staphylococcus aureus in a pediatric cardiothoracic surgery unit.Infect Control Hosp Epidemiol. 2002; 23: 77-81
- A hospital-acquired outbreak of methicillin-resistant Staphylococcus aureus infection initiated by a surgeon carrier.J Hosp Infect. 2001; 47: 104-109
- A cloud adult: the Staphylococcus aureus-virus interaction revisited.Ann Intern Med. 1996; 124: 539-547
- Guideline for prevention of surgical site infection.Am J Infect Control. 1999; : 97-132
Article info
Footnotes
☆Sponsored by the Office of Continuing Medical Education at Excerpta Medica and supported by an educational grant from GlaxoSmithKline.
Identification
Copyright
© 2003 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
