title: Experience in prevention of sternal wound infections in nasal carriers of Staphylococcus aureus.
abstract: Nosocomial and surgical-site infections are significant burdens to the health care system that account for $5 billion and $1.6 billion each year in the United States, respectively. These infections are associated with significant morbidity and mortality rates, increased length of hospitalization, and increased treatment costs that are often not reimbursed by third-party payers. Approximately 40% of sternal wound infections in cardiac surgery patients are caused by Staphylococcus aureus and the prevalence of methicillin-resistant S aureus (MRSA) has risen dramatically in the past 2 to 3 decades. The economic burden that is associated with MRSA is significant; infections caused by MRSA cost approximately $3700 more to treat than infections caused by methicillin-sensitive S aureus, and the death rate for MRSA infection is nearly 3 times that of methicillin-sensitive S aureus. Thus, interventions to prevent nosocomial infection in patients who undergo cardiac surgery may improve outcomes and decrease costs. Advances in diagnostic testing may help to target intranasal antibiotic therapy to those patients who are most likely to receive a benefit. The LightCycler System is a fast and effective polymerase chain reaction-based diagnostic test that may be used to identify patients with nasal colonization of S aureus. Carrier status can be determined in a matter of hours rather than days as is the case with traditional culture techniques.
authors.affiliation: Cleveland Clinic Heart Center, 9500 Euclid Avenue, Desk F25, Cleveland, OH 44195, USA.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Banbury
mesh_terms: D002353:Carrier State / Q000382:microbiology*; D003362:Cost-Benefit Analysis; D006801:Humans; D016712:Mupirocin / Q000627:therapeutic use; D016133:Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D013249:Sternum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D016712:Mupirocin