M Neumaier1, I Kappstein, M A Scherer. 1. Abteilung für Unfallchirurgie, Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität, München.
Abstract
BACKGROUND: The worldwide rise of MRSA is equivalent to an increase of nasal colonization with MRSA. The objectives of this study were to investigate the rate of occult nasal MRSA colonization in trauma patients, to elucidate the role of MRSA carriers for endogenous infection (nose --> wound) and to check the efficiency of mupirocin therapy. PATIENTS AND METHODS: A total of 643 consecutive trauma patients underwent MRSA screening (nasal swabs) on admission. At the same time all MRSA wound infections were registered and all isolates were analysed with PFGE (pulsed-field gel electrophoresis) to detect cross-infection between individuals. RESULTS: In 13 patients (2.0%) we found MRSA in the nose and limited isolation as well as therapy with mupirocin were performed. No endogenous transmission of MRSA from the nose to the wound could be seen, and no cross-infection to other patients could be detected. CONCLUSION: Our findings suggest that in our patients with nasal colonization the risk of intra- and interindividual transmission of MRSA is very small. Therefore, in trauma patients screening on admission does not seem to be absolutely necessary either for clinical or for epidemiological reasons.
BACKGROUND: The worldwide rise of MRSA is equivalent to an increase of nasal colonization with MRSA. The objectives of this study were to investigate the rate of occult nasal MRSA colonization in traumapatients, to elucidate the role of MRSA carriers for endogenous infection (nose --> wound) and to check the efficiency of mupirocin therapy. PATIENTS AND METHODS: A total of 643 consecutive traumapatients underwent MRSA screening (nasal swabs) on admission. At the same time all MRSA wound infections were registered and all isolates were analysed with PFGE (pulsed-field gel electrophoresis) to detect cross-infection between individuals. RESULTS: In 13 patients (2.0%) we found MRSA in the nose and limited isolation as well as therapy with mupirocin were performed. No endogenous transmission of MRSA from the nose to the wound could be seen, and no cross-infection to other patients could be detected. CONCLUSION: Our findings suggest that in our patients with nasal colonization the risk of intra- and interindividual transmission of MRSA is very small. Therefore, in traumapatients screening on admission does not seem to be absolutely necessary either for clinical or for epidemiological reasons.
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