title: Incidence of Methicillin-Resistant Staphylococcus aureus (MRSA) Carrier Status in Patients Undergoing Post-Mastectomy Breast Reconstruction.
abstract: BACKGROUND
  The incidence of methicillin-resistant Staphylococcus aureus (MRSA) carriers and infections continues to rise. Some specialties have demonstrated a reduction in infection through appropriate screening and treatment.
  
  
  OBJECTIVE
  We sought to investigate the incidence of preoperative colonization, postoperative conversion, and whether this had any impact on outcomes in patients undergoing post-mastectomy breast reconstruction (BR).
  
  
  METHODS
  This is a prospective study of a series of 122 BR patients from a single surgeon from May 2013 to March 2015. Nasal swabs were obtained at preoperative and postoperative clinic visits. The incidence of preoperative and postoperative colonization, demographic, and clinical variables were analyzed and compared to complication rates within 90 days of surgery.
  
  
  RESULTS
  The incidence of MRSA colonization was 3.3% (n = 4) preoperatively and 4.1% (n = 5) postoperatively. One patient was positive at both time points, and 4 patients converted postoperatively. Preoperative or postoperative colonization with MRSA was not associated with any specific patient demographics. Hospital length of stay tended to be longer in patients colonized both preoperatively (2.8 days vs 1.6 days, P = .075) and postoperatively (2.8 days vs 1.8 days, P = .072). Postoperative colonization trended toward an increased incidence of any complication (80.0% vs 35.7%, P = .068) and was significantly associated with delayed wound healing (40.0% vs 4.8%, P = .035). Having a minor complication (P = .073) and implant exposure (P = .056) tended to be associated with postoperative carriers.
  
  
  CONCLUSIONS
  The incidence of MRSA in breast reconstruction patients is relatively low, yet complications rates are higher in those patients. Multicenter randomized trials should be conducted to determine if there is a role for preoperative screening and treatment of MRSA carriers.
  
  
  METHODS
  2 Risk.
authors.affiliation: From the Division of Plastic Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hart
authors.affiliation: From the Division of Plastic Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Karan
authors.initials: K
authors.lastname: Desai
authors.affiliation: From the Division of Plastic Surgery, Emory University School of Medicine, Atlanta, GA.
authors.forename: Jason
authors.initials: J
authors.lastname: Yoo
authors.affiliation: From the Division of Plastic Surgery, Emory University School of Medicine, Atlanta, GA alosken@emory.edu.
authors.forename: Albert
authors.initials: A
authors.lastname: Losken
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing