Implications of Methicillin-Resistant Staphylococcus aureus Carriage on Cardiac Surgical Outcomes.

ABSTRACT Background Staphylococcus aureus remains the most common cause of sternal surgical site infections (SSI). Opinions regarding the postoperative implications of preoperative MRSA colonization currently differ. This study aimed to investigate whether MRSA carriage affects postoperative outcomes and safety of operation. Methods A total of 1,774,811 cardiac surgery patients 2009-2014 were identified from the NIS database. Among these, 5,798 (0.33%) were MRSA carriers. Propensity-score matching was used to determine the effect of MRSA colonization on outcomes. Results MRSA carriers did not differ in age or sex from non-carriers, but more often presented for urgent surgery (p=0.0006). Among matched pairs, there was no difference in mortality (p=0.76), stroke, SSI, pneumonia, renal failure, cardiac complications, respiratory failure, or prolonged mechanical ventilation. MRSA infection (p Conclusions MRSA carriers undergoing cardiac surgery are not at higher risk for mortality or SSI and can expect outcomes similar to those of non-carriers. Higher rates of postoperative MRSA infection and septicemia among carriers, although still very low, support the need for selective preoperative screening and prophylaxis when possible.