Surveillance Culture at Hospitalization

Abstract

Purpose: A surveillance culture at hospitalization was performed to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) carriers in order to prevent postoperative and nosocomial infections caused by MRSA. Methods: Bacterial investigations were performed within 48 hours after admission in 762 patients who were hospitalized for more than 4 days. The frequency of MRSA in the samples (carrier rate) and the correlation between the carrier rate and a history of previous hospitalization (HPH) were analyzed. The prophylactic administration of antibiotics in carriers who underwent surgery and the development of postoperative and nosocomial MRSA infections were also assessed. Results: A total of 1,601 samples consisting of 761 throat swabs, 732 stool samples, and 108 other samples were examined. The carrier rate of MRSA was 8.5%. This rate increased to 11.8% in the 493 patients with HPH and to 15.2% in the 341 patients with HPH within 1 year. Of the 37 carriers who underwent surgery, 15 were administered antibiotics that were effective against MRSA, and no postoperative MRSA infection was observed. Nosocomial MRSA infection was observed in only 1 non-carrier. Conclusions: HPH, especially within 1 year, is a high-risk factor for MRSA carriage. Strict observation of standard precautions can prevent outbreaks of nosocomial MRSA infection. Selective administration of effective antibiotics not only prevents postoperative MRSA infections but also reduces the development of new strains of resistant bacteria.