Abstract
The 15-bed SICU between August 1991 and July 1992 had their anterior nares cultured. Cultures positive for S. aureus were subsequently placed on oxacillin-containing plates to screen for methicillin-resistance. Of 484 patients, 19 had MRSA nasal colonization (3.9%). There were five infections in the 19 patients with positive perioperative nasal cultures versus six infections in the remaining 465 patients (P < 0.0001). Immunoblot typing confirmed the concordance of colonizing and infecting strains. Prior exposure to the spinal cord injury center (P < 0.001) and prior antibiotic therapy (P < 0.003) were also significant multivariate risk factors for perioperative nasal colonization. Patients with perioperative MRSA nasal colonization are at significantly increased risk of subsequent postoperative MRSA infection. Address correspondence and reprint requests to Douglas R. Mest, MD, University of California-Irvine Medical Center, Department of Anesthesiology, Rte. 81A, 101 City Drive South, Orange, CA 92668. The authors gratefully acknowledge the technical assistance of June Zaccari and Sara Clack in preparation of this manuscript. This paper would not have been possible without the help of our dedicated Surgical Intensive Care Unit nurses and Microbiology Laboratory staff. The authors are also indebted to Richard Kwok for preparation and execution of the immunoblot typing as well as to Diana Lug0 for secretarial assistance. Accepted for publication November 30, 1993. © 1994 International Anesthesia Research Society...