Methicillin-resistant Staphylococcus aureus nasal colonization in cardiovascular surgery patients at a university hospital in Bogotá, Colombia

哥伦比亚波哥大一家大学医院心血管外科手术患者鼻腔内耐甲氧西林金黄色葡萄球菌定植情况

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Abstract

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a microorganism that colonizes nostrils and different parts of the body, which is considered a risk factor to acquire invasive infections, especially in cardiovascular surgery patients. Objective: To determine the frequency of nasal colonization by MRSA and to establish the clinical characteristics in patients scheduled for cardiovascular surgery. Materials and methods: This was a descriptive study conducted between February and December, 2015. We included adult patients scheduled for cardiovascular surgery at the Hospital Universitario San Ignacio in Bogotá, Colombia. Colonization was identified by real-time PCR from nasal swabs. Colonized patients were treated with mupirocin 2.0% intranasally twice a day and bathed with chlorhexidine 4% from the neck downwards for five days. At the end of this treatment, PCR control was carried out. Results: We included 141 patients with a percentage of nasal colonization of 13.4% (19/141). There were 52 hospitalized patients and 89 outpatients with a percentage of nasal colonization of 17.3% (9/52), and 11.2% (10/89), respectively. All colonized patients who received treatment had a negative PCR at the end of the regime and none of the participating patients had a surgical site infection by S. aureus at the end of the study. Conclusions: Nasal colonization was observed both in hospitalized patients and outpatients. Decolonization treatment with mupirocin was effective to eradicate the carrier state in the short term, which could impact the rates of surgical wound infection associated with cardiovascular surgery.

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