Abstract: Slide Presentations |

The benefits of a Methcillin Resistant Staphylococcus Aureus (MRSA) prevention policy on thoracic surgical practice FREE TO VIEW

John E. Pilling, MBBS*; Antonio Martin-Ucar, MD; David Jenkins, MD; David Waller, MD, FCCP
Author and Funding Information

Glenfield Hospital, Leicester, United Kingdom


Chest. 2004;126(4_MeetingAbstracts):775S. doi:10.1378/chest.126.4_MeetingAbstracts.775S-a
Text Size: A A A
Published online


PURPOSE:  In response to a series of MRSA related post operative complications a policy of pre admission screening and in hospital quarantine was implemented. A course of community eradication therapy prior to admission was instituted where appropriate but patients were not denied admission on the basis of their MRSA status. We have audited the clinical effects of this prevention policy.

METHODS:  All MRSA positive cultures were identified from 989 consecutive patients undergoing thoracic surgery in a single surgeon practice. Two distinct 18 months periods, before and after the introduction of the policy were compared. The rate of clinically significant infection; ITU admission and mortality due to MRSA were recorded. Clinically significant infection was defined as that treated with antibiotics in the presence of a positive culture with either leukocytosis, pyrexia or clinical evidence of infection.

RESULTS:  This policy has reduced the risk of significant, post-operative, nosocomial MRSA infection from 6.9% to 2.0% (see tableTotalWoundPneumoniaPleural empyemaPre (n=496)34 (6.9%)25 (5.0%)14 (2.8%)5 (1.0%)Post (n=493)10 (2%)6 (1.2%)5 (1.0%)3 (0.6%)χ20.00020.00050.03NS). However the rate of ITU admission [6 (1.2%) vs 6 (1.2%)] and mortality [6 (1.2%) vs 5(1.0%)] due to MRSA infection was not significantly different in the two periods. The major reservoir of MRSA import onto our ward was from interhospital transfers (32% MRSA carriers) and patients transferred back to our ward from intensive care (31% carriers). Only 1.6% of patients screened as outpatients before admission were found to be carriers.

CONCLUSION:  The implementation of this MRSA prevention policy has been justified by clinical benefits although severe infection remains a life threatening complication.

CLINICAL IMPLICATIONS:  A greater suspicion of MRSA carriage and presumption of carriage could add significant value to current MRSA prevention guidelines.

DISCLOSURE:  J.E. Pilling, None.

Wednesday, October 27, 2004

10:30 AM- 12:00 PM




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543