Swabbing Surgical Sites Does Not Improve the Detection of Staphylococcus aureus Carriage in High-Risk Surgical Patients
Methods: Adults undergoing preoperative evaluations in orthopedic and neurosurgical clinics were eligible for participation. Patients with active infections or use of anti-staphylococcal antibiotics within 90 days of evaluation were excluded. For each subject, specimens were collected from the nares and from the proposed surgical site with Transporter Liquid Stuart Culture Swabs (HealthLink, Jacksonville, FL). Samples were inoculated onto methicillin-resistant S. aureus (MRSA)-selective chromogenic agar plates and blood agar plates.
Results: Of the 150 subjects, 80 (53.3%) were women and 70 (46.7%) men. The mean age was 61 years and 77/150 (51.3%) had a BMI > 30. Proposed operations included knee or hip arthroplasty, spine surgery, and brain stimulator placement. Culture results were available for 147/150 subjects. Of the 147 surgical site cultures, 54 (36.7%), 51 (34.7%), and 28 (19.0%) were collected from knee, hip, and lumbar sites, respectively; the remaining 14 (9.5%) were from cervical, thoracic, or infraclavicular sites. Overall, 35/147 (23.8%) nasal cultures grew S. aureus; 29/147 (19.7%) grew methicillin-susceptible S. aureus (MSSA), and 6/147 (4.1%) grew MRSA. Only 2/147 (1.4%) surgical site cultures grew S. aureus; both grew MSSA and MSSA was cultured also from the nasal swabs of these subjects. Using nasal culture + surgical site culture as “true positive”, the percentage of additional S. aureus carriers detected by the addition of surgical site screening was zero as compared to nasal screening alone.
Conclusion: The detection of S. aureus carriage in high-risk surgical patients is not improved by swabbing surgical sites in addition to the nares.
M. Giordani, None
K. Shahlaie, None
E. Klineberg, None
J. Tripet-Diel, None
M. Ihara, None
S. Cohen, None