MRSA infections following colorectal surgery in an enhanced recovery programme.
OBJECTIVE
The aim of this study was to evaluate the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infections in a cohort of patients undergoing elective colorectal resections within an enhanced recovery programme.


METHODS
A prospective database of all patients undergoing colorectal resections by a single surgical team over a 3.5-year period was reviewed. Demographics including age, gender, body mass index, American Society of Anesthesiologists classification, type of surgery (abdominal or pelvic) and whether or not the procedure was laparoscopic or open were analysed. All patients were screened preoperatively and postoperatively and on discharge for MRSA. Patients found preoperatively to be MRSA positive were excluded from the study.


RESULTS
In all, 186 patients underwent colorectal resection over the time reviewed. There were 113 laparoscopic resections, 70 open resections and three laparoscopic converted to open resections. Five patients (2.7%) were found to be MRSA positive postoperatively. All of these had open rather than laparoscopic surgery (P < 0.01). Length of stay for patients that had MRSA infections was significantly longer than those remaining MRSA free (P < 0.05).


CONCLUSIONS
These results suggest that patients who successfully undergo laparoscopic colorectal resections within an enhanced recovery programme have a lower incidence of postoperative MRSA infections.
Department of Colorectal Surgery, Freeman Hospital, Newcastle upon Tyne, UK. awphillips@doctors.net.uk
A W
AW
Phillips
K J
KJ
Cranfield
A F
AF
Horgan
D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003108:Colonic Diseases / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery; D011182:Postoperative Care; D011183:Postoperative Complications / Q000382:microbiology*; D011300:Preoperative Care; D012002:Rectal Diseases / Q000601:surgery; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000382:microbiology*; D018709:Statistics, Nonparametric; D055815:Young Adult