title: Rapid colonization with methicillin-resistant coagulase-negative staphylococci after surgery.
abstract: BACKGROUND
  Antimicrobial resistance may compromise the efficacy of antibiotic prophylaxis before surgery. The aim of this study was to measure susceptibility and clonal distribution of coagulase-negative staphylococci (CoNS) colonizing the skin around the surgery access site before and after the procedure.
  
  
  METHODS
  From March to September 2004, a series of 140 patients undergoing elective major abdominal surgery were screened for CoNS colonization at admission and 5 days after surgery. All isolates were tested for antibiotic susceptibility and genotyped by pulsed-field gel electrophoresis (PFGE).
  
  
  RESULTS
  Colonization rates with CoNS at admission and after surgery were 85% and 55%, respectively. The methicillin-resistant CoNS rate increased from 20% at admission to 47% after surgery (P = 0.001). The PFGE pattern after surgery revealed more patients colonized with identical clones: 8/140 patients (8/119 strains) and 26/140 patients (26/77 strains), respectively (P < 0.001).
  
  
  CONCLUSIONS
  Our results suggest rapid recolonization of disinfected skin by resistant nosocomial CoNS. Larger studies, preferably among orthopedic or cardiovascular patients, are required to clarify whether standard antibiotic prophylaxis with first- or second-generation cephalosporins for CoNS infections may be compromised if the patient requires an additional intervention 5 days or more after the initial surgery.
authors: Division of Infectious Diseases and Hospital Epidemiology, Department of Medicine, University Hospital of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. walter.zingg@hcuge.ch
authors: Walter
authors: W
authors: Zingg
authors: Nicolas
authors: N
authors: Demartines
authors: Alexander
authors: A
authors: Imhof
authors: Gabriela
authors: G
authors: Senn
authors: Christian
authors: C
authors: Ruef
mesh_terms: D034861:Abdominal Wall / Q000382:microbiology; D000328:Adult; D003030:Coagulase; D015331:Cohort Studies; D062109:Dermatologic Surgical Procedures; D004203:Disinfection; D017558:Elective Surgical Procedures; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011300:Preoperative Care; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology*; D013207:Staphylococcal Skin Infections / Q000382:microbiology*; D013514:Surgical Procedures, Operative
chemical_list: D003030:Coagulase