Abstract
Objective: To describe the prevalence and incidence of methicillin resistant Staphylococcus aureus (MRSA) colonisation in patients in the Trauma and Orthopaedic wards of the University Hospital of North Staffordshire.
Design Prospective audit.
Patients and methods: Over a three month period from 1st March to 31st May 2003 359 patients attending the elective orthopaedic outpatient department for major joint surgery were screened at the pre-operative assessment clinic; 105 of these patients were screened again on the elective orthopaedic wards. 197 patients were screened on the trauma wards. 31 patients of other/outlying specialities were screened. Patients whose stay was expected to be for 48 hours or more were included in the audit. Patients were screened for MRSA colonization on admission, transfer and discharge. Colonised patients were treated according to the local infection control policy.
Results: 31 elective orthopaedic patients (29%); 46 trauma patients (23%) and 8 other/outlying patients (26%) were colonized with MRSA. On admission, 23 elective orthopaedic patients (22%), 32 trauma patients (16%), and 7 patients (23%) which were of other/outlying specialties were colonized with MRSA. 22 patients (6.6%) positive on admission, treated with eradication therapy, became negative on discharge. An additional 22 patients (6.6%) positive on admission became negative on discharge without receiving any treatment. During the audit period, 23 patients (6.9%) were negative for MRSA on admission and positive on discharge. 9 patients (39%) and 20 patients (62.5%) colonised in elective and trauma wards respectively, developed an MRSA infection, which required treatment.
Conclusion: There is a relatively high prevalence of MRSA colonisation in patients admitted to orthopaedic and trauma wards. A proportion (22%) of patients are colonised with MRSA in the short time between testing and admission. Not all patients positive for MRSA following admission to hospital will have been colonised within the nosocomial environment.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
