Internal Medicine

Schweizer: three steps to reduce post-surgical staph infections

MRSA

Staph infections in hospitals are a serious concern, so much so that the term Methicillin-resistant Staphylococcus aureus (MRSA) is as commonly known as MRI. Far less known is that in many of these cases, patients are infecting themselves.

In heart surgeries and knee and joint-replacement procedures, up to 85 percent of staph infections after surgery come from patients’ own bacteria, according to a 2002 study in the New England Journal of Medicine.

Despite the threat that staph bacteria pose to patients, there is no uniformly accepted procedure to reduce surgical-site infections in the United States. Now, a team of researchers led by the University of Iowa is recommending guidelines that will cut the infection rate by 71 percent for staph bacteria and 59 percent for a broader class of infectious agents known as gram-positive bacteria. In a paper published Thursday (June 13) in the British Medical Journal, the researchers recommend three steps to reduce post-surgical staph infections:

• Swab patients’ noses for two strains of staph (MRSA and MSSA) before surgery.

• For the 30 percent of patients who have staph naturally in their noses, apply a anti-bacterial nose ointment in the days before surgery.

• At surgery, give an antibiotic specifically for MRSA to patients who have the MRSA strain in their noses; for all others, give a more general antibiotic.

Marin Schweizer, an assistant professor of internal medicine at the UI and the lead author on the BMJ paper, notes the nose ointment costs around $20 a tube and is usually covered by health insurance. “We now know we can target staph where it exists naturally in some patients, which is in the nose,” she says. “That’s the bull's-eye, and we can wipe it out. What we are recommending is a really simple, cheap solution to a big problem.”

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