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- Title
- THE IMPACT OF PRE-OPERATIVE MUPIROCIN PROPHYLAXIS ON SURGICAL SITE INFECTIONS IN SAME-DAY ADMISSION OPEN HEART PATIENTS.
- Creator
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Gerry, Joanna, Wink, Diane, University of Central Florida
- Abstract / Description
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ABSTRACT The CDC estimates that one in 20 patients admitted to the hospital is a carrier of methicillin-resistant Staphylococcus aureus (MRSA). Staphylococci are commonly found on the skin and mucous membranes within the anterior nares, which provides the principle reservoir for this organism. These organisms can go on to cause surgical site infections in hospitalized patients. Mupirocin is an effective topical medication used to eliminate nasal carriage of Staphylococcus aureus (S. aureus)....
Show moreABSTRACT The CDC estimates that one in 20 patients admitted to the hospital is a carrier of methicillin-resistant Staphylococcus aureus (MRSA). Staphylococci are commonly found on the skin and mucous membranes within the anterior nares, which provides the principle reservoir for this organism. These organisms can go on to cause surgical site infections in hospitalized patients. Mupirocin is an effective topical medication used to eliminate nasal carriage of Staphylococcus aureus (S. aureus). Based on Level A evidence, the 2007 Society of Thoracic Surgeons has made a Class I recommendation for the use of mupirocin for all patients undergoing cardiac surgery in the absence of documentation of a negative culture for staphylococcal colonization. The purpose of this before-and-after study is to examine the rates of surgical site infections (SSI) for cardiac surgery patients who came through the pre-admission testing unit prior to same-day admission (SDA) for surgery before and after providing 2% mupirocin nasal ointment. Specific aims: 1. To examine the relationship between providing mupirocin to the SDA cardiac surgery patient and the prevalence of SSI. 2. To examine the cost-effectiveness of providing mupirocin to the SDA cardiac surgery patient and SSI. 3. To examine the adherence of SDA preoperative cardiac surgery patients and the use of mupirocin preoperatively, if the medication is provided at no cost to the patient. Retrospective chart reviews were completed on 330 patients: 175 patients in the pre-provision of mupirocin and 150 in the mupirocin provided group. Chi Square and studentsÂÂÂÂ' t-tests were used to analyze the data. There were five SSIs in the pre-provision of mupirocin group and no SSIs in the mupirocin provided group. This was a significantly statistical difference between the groups (X2 = 4.497, p < 0.5) Continued provision of 2% nasal mupirocin to prevent SSI in the cardiac surgery patients is recommended.
Show less - Date Issued
- 2010
- Identifier
- CFE0003342, ucf:48461
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0003342
- Title
- THE INCIDENCE AND EPIDEMIOLOGIC FACTORS OF COMMUNITY-ACQUIRED METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS SKIN AND SOFT TISSUE INFECTIONS IN A SUBURBAN FAMILY PRACTICE IN FLORIDA.
- Creator
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Johnson, Ivonne, Rash, Elizabeth, University of Central Florida
- Abstract / Description
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Methicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem nationwide, threatening to develop into an epidemic. Many of these patients are presenting to their primary care clinics with skin and soft tissue infections (SSTIs). The CDC has reported that in 2005, MRSA was responsible for an estimated 94,000 life-threatening infections and 16,650 deaths. The purpose of this study is to estimate the incidence of CA-MRSA within a specific family practice in Florida and to...
Show moreMethicillin-resistant Staphylococcus aureus (MRSA) is a serious public health problem nationwide, threatening to develop into an epidemic. Many of these patients are presenting to their primary care clinics with skin and soft tissue infections (SSTIs). The CDC has reported that in 2005, MRSA was responsible for an estimated 94,000 life-threatening infections and 16,650 deaths. The purpose of this study is to estimate the incidence of CA-MRSA within a specific family practice in Florida and to identify epidemiologic factors, classify antibiotic susceptibility patterns, and evaluate patient education in regard to disease management and prevention. This study was a descriptive, epidemiologic, three-year retrospective medical record review of all wound cultured skin and soft tissue infections that presented to a family practice between January 2007 and December 2009. Sixty-two medical records met the inclusion and exclusion criteria for the study. Of these 62 SSTIs, 44 cultures grew one or more bacterial organisms. The incidence of CA-MRSA was 66% (n=29). The mean age of those with CA-MRSA was 40 years old, with a range from 7 to 90 years old. Sixty-two percent (n=18) were male and 38% (n=11) were female; additionally 69% (n=20) lived within a 10 mile radius from the family practice, while 31% (n=9) lived in a surrounding suburb. The most frequent race was Caucasian 83% (n=24), with African American at 10% (n=3) and Hispanics 7% (n=2). Risk factors associated with CA-MRSA was obesity 41% (n=10), diabetes mellitus 24% (n=7), and a previous history of MRSA infection 24% (n=7). Skin and soft tissue infections were diagnosed as either an abscess 62% (n=18), boil 24% (n=7), pustule 10% (n=3), or cellulitis 4% (n=1). CA-MRSA isolates were susceptible to trimethoprim-sulfamethoxazole 100% (n=29), doxycycline 93% (n=27), and rifampin 100% (n=14). Clindamycin susceptibility was 65% (n=15) with resistance at 30% (n=7) and 5% (n=1) intermediate. Both cephalexin and erythromycin were 100% resistant. Documentation in the medical record on wound care was found in 45% (n=13) of the records. The incidence of CA-MRSA SSTI was 66%, which identifies this suburban community at high risk for this bacterial infection. Risk factors associated with CA-MRSA included obesity (BMI >30), history of previous MRSA infection, and diabetes mellitus. There were no clinical characteristics that helped distinguish MRSA infection from other bacterial SSTIs. Most SSTI were treated with incision and drainage and a susceptible antibiotic. Judicious use of antibiotics not only provides appropriate treatment, but is also critical in prevention of antibiotic resistance. Lastly, patient education in adequate hygiene is essential in preventing the spread of CA-MRSA
Show less - Date Issued
- 2010
- Identifier
- CFE0003309, ucf:48495
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0003309
