RATES OF MRSA SCREENING, CARRIER STATUS AND WOUND INFECTION IN AUSTIN MOORE HEMI-ARTHROPLASTY PATIENTS : A 1 YEAR RETROSPECTIVE SURVEY

Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) has increased in prevalence and significance over the past ten years. Studies have shown rates of MRSA in Trauma and Orthopaedic populations to be from 1.6% to 38%. Rates of MRSA are higher in long term residential care.

It has been Department of Health policy to screen all Trauma and Orthopaedic patients for MRSA since 2001. This study audited rates of MRSA screening in patients who presented with fractured neck of femur treated with Austin Moore hemi-arthroplasty over the course of one year. Rates of MRSA carriage and surgical site infection (SSI) were derived from the computerised PAS system and review of case notes.

9.8 % of patients were not screened for MRSA at any time during their admission. The rate of MRSA carriage within the study population was 9.2%. The MRSA SSI rate was 4.2%. MRSA infections are associated with considerable cost and qualitative morbidity and mortality.

There is good evidence for the use of nasal muprocin and triclosan baths in reducing MRSA. Single dose Teicoplanin has been shown to be as effective as traditional cephalosporin regimes. There is new guidance for the use of prophylactic Teicoplanin for prevention of SSI. We should consider introducing both topical and antimicrobial MRSA prophylaxis.