title: Methicillin-resistant Staphylococcus aureus infections following esophageal surgery in patients with impaired defense mechanisms.
abstract: This study was conducted to determine whether or not compromised host defense mechanisms prior to surgery are related to postoperative infections with methicillin-resistant Staphylococcus aureus (MRSA). Neutrophil cytocidal activities, serum complement and immunoglobulin levels, the in vivo antibody-producing capacity against pneumococcal polysaccharide (PPS), and cell-mediated immunity (CMI) were evaluated in 22 patients who underwent esophagectomy for esophageal cancer between 1989 and 1990. Postoperatively, nine patients developed MRSA infections. Anti-PPS IgG was found to be significantly lower in patients with MRSA infections than in those without (P < 0.01). All the patients with MRSA infections showed a titer < 600 EU, while all but one of the non-infected patients showed a titer > 600 EU. Impairment in other components of the defense mechanisms, apart from a partial deficiency of CMI, did not differ between the groups. Thus, a preoperative evaluation of the antibody-producing capacity may serve to predict the development of MRSA-related infections following major surgery such as esophagectomy.
authors.affiliation: First Department of Surgery, Oita Medical University, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Saito
authors.forename: T
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Y
authors.initials: Y
authors.lastname: Shigemitsu
authors.forename: T
authors.initials: T
authors.lastname: Katsuta
authors.forename: K
authors.initials: K
authors.lastname: Shimoda
authors.forename: M
authors.initials: M
authors.lastname: Kobayashi
mesh_terms: D000368:Aged; D003165:Complement System Proteins / Q000032:analysis; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007111:Immunity, Cellular; D007136:Immunoglobulins / Q000032:analysis; D008297:Male; D016106:Methicillin Resistance; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology; D011135:Polysaccharides, Bacterial / Q000276:immunology; D011183:Postoperative Complications; D013203:Staphylococcal Infections / Q000209:etiology*
chemical_list: D007136:Immunoglobulins; D011135:Polysaccharides, Bacterial; D003165:Complement System Proteins