Methicillin-resistant Staphylococcus aureus-associated infections following septorhinoplasty.
Septorhinoplasty is associated with postoperative infection in less than 2% of cases, even without the use of prophylactic antibiotics. However, there is a concern that increasingly prevalent, highly virulent pathogens such as MRSA may predispose to postoperative infections. Over the past several decades, MRSA has emerged as the most important cause of antibiotic-resistant nosocomial infection. MRSA-associated infections related to nasal surgery are underreported in the literature. We present a case of MRSA-associated infection following a routine septorhinoplasty in a health care worker. We discuss the incidence of this complication and contributing risk factors. The classification of MRSA-associated infections into genotypically distinct hospital-acquired and community-acquired subtypes is reviewed, and the associated differences in epidemiology, clinical presentation, and antibiotic susceptibility are discussed. A comprehensive strategy incorporating diagnostic workup, preventative management based upon preoperative risk stratification, and treatment of MRSA-associated soft tissue infections is presented.
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, 1904 Taubman Center 1500 E. Medical CenterDr., Ann Arbor, MI 48109, USA. alwalee@med.umich.edu
Waleed M
WM
Abuzeid
Michael G
MG
Brandt
Jeffrey S
JS
Moyer
Shan R
SR
Baker
D000038:Abscess / Q000175:diagnosis; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055624:Methicillin-Resistant Staphylococcus aureus / Q000502:physiology*; D055171:Nasal Cartilages / Q000601:surgery; D015508:Nasal Obstruction / Q000601:surgery; D009300:Nasal Septum / Q000601:surgery*; D010027:Osteotomy / Q000379:methods; D012225:Rhinoplasty / Q000379:methods*; D013290:Streptococcal Infections / Q000175:diagnosis*; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000382:microbiology*