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Does methicillin-resistant Staphylococcus aureus have a significant role in the peri-operative course of patients undergoing rhinological surgery?

Published online by Cambridge University Press:  09 June 2008

C M Philpott ,
A Sharma  and
D C McKiernan
C M Philpott*
Affiliation:
Department of Otorhinolaryngology, West Suffolk Hospital, Bury St Edmunds, UK
A Sharma
Affiliation:
Department of Otorhinolaryngology, West Suffolk Hospital, Bury St Edmunds, UK
D C McKiernan
Affiliation:
Department of Otorhinolaryngology, West Suffolk Hospital, Bury St Edmunds, UK
*
Address for correspondence: Mr Carl Philpott, 2804 Alberni Street, Vancouver, British Columbia, Canada, V6E 1A6 E-mail: carl.philpott@btinternet.com
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Abstract

Objectives:

Methicillin-resistant Staphylococcus aureus infections are becoming an increasing problem, but the link with symptomatic sino-nasal infection has not previously been quantified. The aim of this study was to determine the incidence of methicillin-resistant Staphylococcus aureus infection in patients undergoing sino-nasal surgery.

Design:

A retrospective study of case notes.

Setting:

A district general hospital.

Patients:

One hundred and fifty-one adult patients undergoing in-patient endonasal surgery over a 12-month period were considered for the study.

Main outcome measures:

Swab results from pre-operative screening and from any intra- and post-operative samples of infective mucopus.

Results:

One hundred and fifty-one patients undergoing endonasal surgery were included. All patients had pre-operative nasal swabs taken. Twenty-five patients had peri-operative microbiology samples taken. Only one middle meatal swab was found to contain methicillin-resistant Staphylococcus aureus. No patients had methicillin-resistant Staphylococcus aureus detected on pre-operative screening. Haemophilus influenzae was the most common organism detected.

Conclusion:

Methicillin-resistant Staphylococcus aureus infection does not represent a significant source of morbidity in our practice.

Keywords

Staphylococcus AureusMicrobial Drug ResistanceMethicillinNasal Surgery

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 2 , February 2009 , pp. 191 - 194
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented as a poster at the British Rhinological Society Meeting, 25 May 2007, London, UK.

References

1Vos, C, Verbrugh, H. MRSA: we can overcome, but who will lead the battle? Infect Control Hosp Epidemiol 2005;26:117–20CrossRefGoogle ScholarPubMed
2Luzar, MA, Coles, GA, Faller, B, Slingeneyer, A, Dah, GD, Briat, C et al. Staphylococcus aureus nasal carriage and infection in patients on continuous ambulatory peritoneal dialysis. N Engl J Med 1990;322:505–9Google Scholar
3Kluytmans, J, van Belkum, A, Verbrugh, H. Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanisms, and associated risks. Clin Microbiol Rev 1997;10:505–20CrossRefGoogle ScholarPubMed
4Armstrong-Esther, CA. Carriage patterns of Staphylococcus aureus in a healthy non-hospital population of adults and children. Ann Hum Biol 1976;3:221–7CrossRefGoogle Scholar
5Williams, R. Healthy carriage of Staphylococcus aureus, its prevalence and importance. Bacteriol Rev 1963;27:56–71CrossRefGoogle ScholarPubMed
6Reagan, DR, Doebbeling, BN, Pfaller, MA, Sheetz, CT, Houston, AK, Hollis, RJ et al. Elimination of coincident Staphylococcus aureus nasal and hand carriage with intranasal application of mupirocin calcium ointment. Ann Intern Med 1991;114:101–6CrossRefGoogle ScholarPubMed
7Parras, F, Guerrero, MC, Bouza, E, Blazquez, MJ, Moreno, S, Menarguez, MC et al. Comparative study of mupirocin and oral co-trimoxazole plus topical fusidic acid in eradication of nasal carriage of methicillin-resistant Staphylococcus aureus. Antimicrob Agents Chemother 1995;39:175–9Google Scholar
8Asensio, A, Canton, R, Vaque, J, Rossello, J, Calbo, F, Garcia-Caballero, J et al. Nosocomial and community-acquired methicillin-resistant Staphylococcus aureus infections in hospitalized patients (Spain, 1993–2003). J Hosp Infect 2006;63:465–71CrossRefGoogle ScholarPubMed
9Mainous, AG 3rd, Hueston, WJ, Everett, CJ, Diaz, VA. Nasal carriage of Staphylococcus aureus and methicillin-resistant S aureus in the United States, 2001–2002. Annals of Family Medicine 2006;4:132–7CrossRefGoogle ScholarPubMed
10Stefani, S, Varaldo, PE. Epidemiology of methicillin-resistant staphylococci in Europe. Clinical Microbiology and Infection 2003;9:1179–86Google Scholar
11Tiemersma, EW, Bronzwaer, SL, Lyytikainen, O, Degener, JE, Schrijnemakers, P, Bruinsma, N et al. Methicillin-resistant Staphylococcus aureus in Europe, 1999–2002. Emerg Infect Dis 2004;10:1627–34Google Scholar
12Noble, W, Williams, R, Jevons, M, Shooter, R. Some aspects of nasal carriage of staphylococci. J Clin Pathol 1964;17:79–83CrossRefGoogle ScholarPubMed
13Loeb, M, Main, C, Walker-Dilks, C, Eady, A. Antimicrobial drugs for treating methicillin-resistant Staphylococcus aureus colonization. Cochrane Review. The Cochrane Library Issue 3 ed. Chichester: Wiley, 2004Google Scholar
14Coia, JE, Duckworth, GJ, Edwards, DI, Farrington, M, Fry, C, Humphreys, H et al. Guidelines for the control and prevention of methicillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities. J Hosp Infect 2006;63 (suppl 1):S1–44CrossRefGoogle ScholarPubMed
15Mody, L, Kauffman, C, McNeill, S, Galecki, A, Bradley, S. Mupirocin-based decolonization of Staphylococcus aureus carriers in residents of 2 long-term care facilities: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis 2003;37:1467–74CrossRefGoogle ScholarPubMed
16Yu, VL, Goetz, A, Wagener, M, Smith, PB, Rihs, JD, Hanchett, J et al. Staphylococcus aureus nasal carriage and infection in patients on hemodialysis. Efficacy of antibiotic prophylaxis. N Engl J Med 1986;315:91–6CrossRefGoogle ScholarPubMed
17Nguyen, MH, Kauffman, CA, Goodman, RP, Squier, C, Arbeit, RD, Singh, N et al. Nasal carriage of and infection with Staphylococcus aureus in HIV-infected patients. Ann Intern Med 1999;130:221–5CrossRefGoogle ScholarPubMed
18von Eiff, C, Becker, K, Machka, K, Stammer, H, Peters, G. Nasal carriage as a source of Staphylococcus aureus bacteremia. Study Group. N Engl J Med 2001;344:11–16CrossRefGoogle ScholarPubMed
19Corne, P, Marchandin, H, Jonquet, O, Campos, J, Banuls, AL. Molecular evidence that nasal carriage of Staphylococcus aureus plays a role in respiratory tract infections of critically ill patients. J Clin Microbiol 2005;43:3491–3Google Scholar
20Moss, B, Squire, J, Topley, E. Nose and skin carriage of Staphylococcus aureus in patients receiving penicillin. Lancet 1948;i:320–5CrossRefGoogle Scholar
21Troche, G, Joly, LM, Guibert, M, Zazzo, JF. Detection and treatment of antibiotic-resistant bacterial carriage in a surgical intensive care unit: a 6-year prospective survey. Infect Control Hosp Epidemiol 2005;26:161–5Google Scholar
22Orsi, GB, Raponi, M, Franchi, C, Rocco, M, Mancini, C, Venditti, M. Surveillance and infection control in an intensive care unit. Infect Control Hosp Epidemiol 2005;26:321–5Google Scholar
23Gerencer, RZ. Successful outpatient treatment of sinusitis exacerbations caused by community-acquired methicillin-resistant Staphylococcus aureus. Otolaryngol Head Neck Surg 2005;132:828–33CrossRefGoogle ScholarPubMed
24Sharma, A, Philpott, C, Pope, L, McKiernan, D. Methicillin resistant Staphylococcus aureus: is it a problem for nasal surgery? J Laryngol Otol 2007;121:415–18Google Scholar
25Huang, WH, Hung, PK. Methicillin-resistant Staphylococcus aureus infections in acute rhinosinusitis. Laryngoscope 2006;116:288–91CrossRefGoogle ScholarPubMed
26Wertheim, HF, Melles, DC, Vos, MC, van Leeuwen, W, van Belkum, A, Verbrugh, HA et al. The role of nasal carriage in Staphylococcus aureus infections. Lancet Infect Dis 2005;5:751–62CrossRefGoogle ScholarPubMed
27Jiang, RS, Jang, JW, Hsu, CY. Post-functional endoscopic sinus surgery methicillin-resistant Staphylococcus aureus sinusitis. Am J Rhinol 1999;13:273–7Google Scholar
28Jiang, RS, Hsu, CY, Jang, JW. Bacteriology of the maxillary and ethmoid sinuses in chronic sinusitis. J Laryngol Otol 1998;112:845–8Google Scholar
29Biel, MA, Brown, CA, Levinson, RM, Garvis, GE, Paisner, HM, Sigel, ME et al. Evaluation of the microbiology of chronic maxillary sinusitis. Ann Otol Rhinol Laryngol 1998;107:942–5Google ScholarPubMed
30Brook, I, Frazier, EH, Foote, PA. Microbiology of chronic maxillary sinusitis: comparison between specimens obtained by sinus endoscopy and by surgical drainage. J Med Microbiol 1997;46:430–2Google Scholar
31Doyle, PW, Woodham, JD. Evaluation of the microbiology of chronic ethmoid sinusitis. J Clin Microbiol 1991;29:2396–400CrossRefGoogle ScholarPubMed
32Sener, B, Hascelik, G, Onerci, M, Tunckanat, F. Evaluation of the microbiology of chronic sinusitis. J Laryngol Otol 1996;110:547–50Google Scholar
33Almadori, G, Bastianini, L, Bistoni, F, Maurizi, M, Ottaviani, F, Paludetti, G et al. Microbial flora of nose and paranasal sinuses in chronic maxillary sinusitis. Rhinology 1986;24:257–64Google Scholar
34Aral, M, Keles, E, Kaygusuz, I. The microbiology of ethmoid and maxillary sinuses in patients with chronic sinusitis. Am J Otolaryngol 2003;24:163–8CrossRefGoogle ScholarPubMed
35Aral, M, Keles, E, Okur, E, Alpay, HC, Yilmaz, M. The pathogenicity and antibiotic resistance of coagulase-negative staphylococci isolated from the maxillary and ethmoid sinuses. Rhinology 2004;42:131–6Google Scholar
36Orobello, PW Jr, Park, RI, Belcher, LJ, Eggleston, P, Lederman, HM, Banks, JR et al. Microbiology of chronic sinusitis in children. Arch Otolaryngol Head Neck Surg 1991;117:980–3Google Scholar
37Eviatar, E, Kessler, A, Segal, S, Vaiman, M, Kalmovich, LM. Effects of septoplasty on the nasal flora. Am J Rhinol 2006;20:40–2CrossRefGoogle ScholarPubMed
38Suzuki, K, Nishimura, T, Baba, S. Current status of bacterial resistance in the otolaryngology field: results from the Second Nationwide Survey in Japan. J Infect Chemother 2003;9:46–52Google Scholar
39Damm, M, Quante, G, Jurk, T, Sauer, JA. Nasal colonization with Staphylococcus aureus is not associated with the severity of symptoms or the extent of the disease in chronic rhinosinusitis. Otolaryngol Head Neck Surg 2004;131:200–6Google Scholar
40Vaidya, AM, Chow, JM, Stankiewicz, JA, Young, MR, Mathews, HL. Correlation of middle meatal and maxillary sinus cultures in acute maxillary sinusitis. Am J Rhinol 1997;11:139–43Google Scholar
41Dubin, MG, Ebert, CS, Coffey, CS, Melroy, CT, Sonnenburg, RE, Senior, BA. Concordance of middle meatal swab and maxillary sinus aspirate in acute and chronic sinusitis: a meta-analysis. Am J Rhinol 2005;19:462–70Google Scholar
42Brook, I. Microbiology and management of sinusitis. J Otolaryngol 1996;25:249–56Google Scholar