title: Incidence of MRSA surgical-site infection in MRSA carriers in an orthopaedic trauma unit.
abstract: We examined the incidence of infection with methicillin-resistant Staphylococcus aureus (MRSA) in patients admitted to the Leicester Royal Infirmary Trauma Unit between January 2004 and June 2006. The influence of MRSA status at the time of their admission was examined, together with age, gender and diagnosis, using multi-variant analysis. Of 2473 patients, 79 (3.2%) were MRSA carriers at the time of admission and 2394 (96.8%) were MRSA-negative. Those carrying MRSA at the time of admission were more likely to develop surgical site infection with MRSA (7 of 79 patients, 8.8%) than non-MRSA carriers (54 of 2394 patients, 2.2%, p < 0.001). Further analysis showed that hip fracture and increasing age were also risk factors with a linear increase in relative risk of 1.8% per year. MRSA carriage at admission, age and the pathology are all associated with an increased rate of developing MRSA wound infection. Identification of such risk factors at admission helps to target health-care resources, such the use of glycopeptide antibiotics at induction and the 'building-in' of increased vigilance for wound infection pre-operatively.
authors.affiliation: Department of Trauma and Orthopaedics, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.
authors.forename: S
authors.initials: S
authors.lastname: Shukla
authors.forename: M
authors.initials: M
authors.lastname: Nixon
authors.forename: M
authors.initials: M
authors.lastname: Acharya
authors.forename: M T
authors.initials: MT
authors.lastname: Korim
authors.forename: R
authors.initials: R
authors.lastname: Pandey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D004739:England / Q000453:epidemiology; D005260:Female; D050723:Fractures, Bone / Q000382:microbiology* / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology* / Q000401:mortality; D014193:Trauma Centers; D055815:Young Adult