Methicillin Resistant Staphylococcus Aureus (MRSA) Eradication Prior to Cardiac Surgery

The problem of methicillin-resistant Staphylococcus aureus (MRSA) infections has led to routine surveillance and decolonisation strategies. Cardiac surgery unit admissions receive MRSA cultures from nares, skin, throat and wounds/groin, and if positive are isolated followed by eradication treatment. This strategy was retrospectively reviewed. The study comprises 50 patients: 32 successfully decolonized/eradicated carriers and 18 unsuccessfully eradicated carriers. A comparison of pre-operative characteristics showed no statistically significant differences between the 2 groups with the exception for asthmatic patients, where there was only 3.1% of MRSA eradicated patients vs 22.2% in the unsuccessful eradication group (p=0.031). There was no difference between the operative patient data of both groups in hospital mortality, post-operative lengths of stay, ventilation time, post op IABP (intra-aortic balloon pump), post-operative complications, Cerebrovascular accidents and Transient Ischaemic attacks as well as long term complications were not statistically significant. However, there is a statistically significant difference between the use of post-operative antibiotics, with 72.2% of unsuccessfully MRSA eradicated patients requiring antibiotics postoperatively, compared to 40.6%, (p=0.032). Preoperative asthmatics were more likely to fail MRSA eradication/decolonisation. Post operatively MRSA eradication results in the reduction in postoperative antibiotic use.