Abstract
This was a prospective study to evaluate the changes in bacterial colonisation of the skin during hospital admission for elective surgery. It involved 48 patients who were admitted the day before surgery to Pretoria Academic and Pretoria East Hospitals. Within two hours of admission, cotton-tipped pus swabs were used to obtain samples from 56 skin sites in 48 patients. Postoperative specimens were obtained the day after surgery. The pre-operative cultures revealed a 73% Coagulase Negative Staphylococcus (CNS). Postoperative cultures revealed a 63% CNS. Preoperative methicillin resistance of the CNS was 6% and postoperative resistance to 49% (p < 0.01). The resistance of the organism to Cefazolin increased from 11% to 37%.
This study clearly indicates that multiple drug-resistant organisms colonise the skin of patients in the perioperative hospital stay. The postoperative rise in methicillin resistance of the CNS was alarming. Questions arising from this study include optimal admission time, length of postoperative stay, choice of perioperative antibiotic, use of occlusive dressings to prevent colonisation of wound site and routine screening for Methicillin-resistant CNS skin contaminants.
The abstracts were prepared by Professor M. B. E. Sweet. Correspondence should be addressed to him at PO Box 47363, Parklands, Johannesburg 2121, South Africa.
