Controlling MRSA in head and neck cancer patients: what works?
OBJECTIVE
We aimed to determine any beneficial effect from targeted surveillance, cohort nursing, and restricted health care worker access in controlling MRSA infection in patients undergoing surgery for head and neck cancer.


METHODS
Historical cohort study.


METHODS
In phase 1 data were gathered on MRSA-positive cases admitted from February 1, 2006 to February 28, 2007. In phase 2, from July 1, 2007 to January 31, 2008, eligible patients underwent screening swabs, cohort nursing, and restricted access.


RESULTS
In the first phase, 24 patients developed MRSA infection out of a total of 84 eligible admissions. There were 31 eligible admissions during phase 2. None of them had known risk factors for MRSA as per Scottish Infection Standards and Strategy Group (SISS) guidelines. All screened patients were noncarriers of MRSA. Three patients out of this group subsequently developed MRSA during their hospital stay. There was a statistically significant drop in MRSA to 9.6 percent (3/31) during this phase compared to 28.5 percent (24/84) in phase 1.


CONCLUSIONS
Head and neck cancer patients are at high risk of acquiring MRSA infection. Their targeted surveillance is unlikely to influence their MRSA infection rate. However, cohort nursing with restricted health care worker access may help control MRSA infection in them.
Supriya
Mrinal
M
Aberdeen Royal Infirmary, Aberdeen, Scotland. mrinal.supriya@nhs.net
Shakeel
Muhammad
M
Santangeli
Louise
L
Ah-See
Kim Wong
KW
D015331:Cohort Studies; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D006258:Head and Neck Neoplasms / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D015994:Incidence; D017053:Infection Control; D008485:Medical Audit; D055624:Methicillin-Resistant Staphylococcus aureus; D012189:Retrospective Studies; D012307:Risk Factors; D012606:Scotland; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*