title: Clinical and cost ineffectiveness of preoperative screening for methicillin-resistant Staphylococcus aureus and intranasal mupirocin in preventing methicillin-resistant S aureus infections in cardiothoracic surgery.
abstract: In our recent experience with methicillin-resistant Staphylococcus aureus (MRSA) infections in 488 patients undergoing thoracic cardiovascular surgery, we found only 2 MRSA infections (one sternal and one graft site). Both patients received preoperative bacitracin and had a negative nares culture for MRSA before the initiation of bacitracin therapy. We conclude that preoperative MRSA screening cultures and bacitracin prophylaxis are neither clinically efficacious nor cost-effective in predicting or preventing MRSA in patients undergoing thoracic cardiovascular surgery.
authors.affiliation: Infectious Disease Division, Winthrop University Hospital, Mineola, New York 11501, USA.
authors.forename: Burke A
authors.initials: BA
authors.lastname: Cunha
authors.forename: Valsamma
authors.initials: V
authors.lastname: Thekkel
authors.forename: Paul
authors.initials: P
authors.lastname: Schoch
authors.forename: Linda
authors.initials: L
authors.lastname: Cosgrove
mesh_terms: D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics; D002353:Carrier State / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D016712:Mupirocin / Q000008:administration & dosage* / Q000191:economics; D009666:Nose / Q000382:microbiology; D011300:Preoperative Care / Q000191:economics / Q000379:methods*; D015995:Prevalence; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D019616:Thoracic Surgical Procedures / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D016712:Mupirocin