title: Screening and treatment of methicillin-resistant Staphylococcus aureus in children undergoing open airway surgery.
abstract: OBJECTIVE
  (1) To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in children undergoing open airway surgery using a screening protocol; (2) to examine the rates of postoperative infection in this cohort; and (3) to determine adherence to a MRSA antibiotic protocol.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Tertiary pediatric referral center.
  
  
  METHODS
  The study population comprised 180 children undergoing 197 open airway operations from January 2007 to March 2009 at the Cincinnati Children's Hospital Medical Center.
  
  
  METHODS
  Methicillin-resistant Staphylococcus aureus screening and treatment protocol.
  
  
  METHODS
  Prevalence of MRSA colonization, postoperative infection rates, colonization rates by site, and adherence to antibiotic protocol.
  
  
  RESULTS
  A total of 180 patients who underwent 197 operations were included in the study. The overall prevalence of MRSA was 32.5%. There were no significant differences between MRSA-colonized and noncolonized patients regarding age at surgery, sex, gestational age at birth, or comorbidities. Postoperative infection rates were similar between the 2 groups (16% MRSA colonized; 17% MRSA noncolonized). Three patients who developed postoperative MRSA infections were MRSA negative on preoperative screening. Intraoperative adherence was high in both groups.
  
  
  CONCLUSIONS
  We describe a MRSA screening and treatment protocol for children undergoing open airway surgery. We found a high prevalence (32.5%) of MRSA colonization in these patients. Treatment of MRSA-colonized patients resulted in postoperative infection rates similar to those in MRSA-noncolonized patients. Treatment of MRSA-colonized patients resulted in no MRSA-associated postoperative infections, graft loss, or dehiscence. MRSA screening and treatment protocols may be helpful in minimizing MRSA-associated postoperative infections in these patients.
authors.affiliation: Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH 45229-30309, USA.
authors.forename: Melissa McCarty
authors.initials: MM
authors.lastname: Statham
authors.forename: Alessandro
authors.initials: A
authors.lastname: de Alarcon
authors.forename: Janet N
authors.initials: JN
authors.lastname: Germann
authors.forename: Meredith E
authors.initials: ME
authors.lastname: Tabangin
authors.forename: Aliza P
authors.initials: AP
authors.lastname: Cohen
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rutter
mesh_terms: D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D009820:Ohio / Q000453:epidemiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000900:Anti-Bacterial Agents