Which patients are most at risk of methicillin resistant Staphylococcus aureus: a review of admissions to a regional maxillofacial ward between 2001 and 2005.
This study aimed to identify all Staphylococcus aureus (MRSA) cases on a Regional Maxillofacial ward, to estimate incidence and to ascertain who were most at risk. The study also explored clinical and demographic factors associated with MRSA in a subset of consecutive patients managed by primary surgery for previously untreated oral and oropharyngeal squamous cell carcinoma (OOSCC) over the same time period. Patients admitted from 1st April 2001 to 31st March 2006 to the Regional Maxillofacial Unit ward, Liverpool were identified by a retrospective review of the hospital MRSA database and there were 10109 patient admissions. MRSA (1.1%) occurred in 115 patient episodes involving 97 patients. There were 84 patients having a single episode and 13 more than one. There were no cases of mortality due to MRSA. Of the MFU patients 73 were oncology and 7 trauma. In the oncology group the commonest primary sites were wound (41) and sputum (11). Of new patients admitted for definitive treatment for OOSCC, 14% had MRSA and the two main risk factors were stage of cancer (P<0.001) and free flap (P<0.001). The risk of MRSA infection on our maxillofacial ward is low though MRSA infection is more prevalent among oncology patients particularly those requiring free tissue transfer. Careful adherence to infection prevention and control precautions is essential and practical methods to reduce MRSA need further evaluation.
Regional Maxillofacial Unit, University Hospital Aintree Foundation Trust, Liverpool, UK. snrogers@doctors.org.uk
Simon N
SN
Rogers
Katarzyna
K
Proczek
Rachel A
RA
Sen
Julie
J
Hughes
Paul
P
Banks
Derek
D
Lowe
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology; D003796:Dental Service, Hospital / Q000706:statistics & numerical data; D004198:Disease Susceptibility; D004739:England / Q000453:epidemiology; D005260:Female; D006767:Hospitals, District; D006801:Humans; D008297:Male; D008446:Maxillofacial Injuries / Q000601:surgery; D016106:Methicillin Resistance; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000601:surgery; D010343:Patient Admission / Q000706:statistics & numerical data*; D012307:Risk Factors; D013183:Sputum / Q000382:microbiology; D013203:Staphylococcal Infections / Q000453:epidemiology*; D013211:Staphylococcus aureus / Q000187:drug effects*; D013524:Surgical Flaps / Q000382:microbiology / Q000706:statistics & numerical data; D013530:Surgical Wound Infection / Q000453:epidemiology*