Evidence-based infection control in thoracic surgery.
OBJECTIVE
Methicillin-resistant Staphylococcus aureus (MRSA) continues to pose a major threat to the lung and cardiovascular surgery patients. We propose evidence-based infection control (EBIC) against MRSA.


METHODS
We conducted a basic study comparing genotyping to cluster analysis using minimal inhibition concentration on 17 drugs for 21 MRSA strains. With or without EBIC using cluster analysis and global evidence, we compared the incidence of postoperative MRSA infection. Notably, we eliminated tweezers stands and emesis basins.


RESULTS
Cluster analysis showed a typing sensitivity of 72%. The use of EBIC decreased MRSA cross-infection in the recovery room. A lung surgery series showed an MRSA incidence of 1/190 before and 0/200 after EBIC was introduced. For a cardiovascular surgery series, the MRSA incidence was 2/169 before and 0/84 after EBIC was introduced. Across wards, MRSA among Staphylococcus aureus in patient fell from 68% in 1999 to 57% in 2000.


CONCLUSIONS
EBIC consisting of global guidelines and cluster analysis was useful in controlling MRSA in lung and cardiovascular surgery patients.
Yoshida
Junichi
J
Department of Surgery, Shimonoseki City Hospital, 1-13-1 Koyo-cho, Shimonoseki 750-8520, Japan.
Kirikae
Teruo
T
Yamanaka
Naoki
N
Suzuki
Hiroyuki
H
Onzuka
Tatsuji
T
Hisahara
Manabu
M
Ueno
Yasutaka
Y
D016000:Cluster Analysis; D019317:Evidence-Based Medicine; D006801:Humans; D016106:Methicillin Resistance; D019990:Perioperative Care; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000187:drug effects; D019616:Thoracic Surgical Procedures