Abstract
The incidence of MRSA infection is increasing worldwide. Costs incurred in treating MRSA infection are over twice that of normal patients, and the duration of hospital stay is up to 10 times longer. Risk factors are age, previous MRSA infection, prolonged hospitalization, patients from convalescent homes, immunocompromised states, vascular and pulmonary disease.
Methods.
A retrospective chart review was conducted on 14 patients who developed MRSA infection in our unit, over a period of six years. Data included: age, gender, neurological status, length of hospital and ICU admission, type of procedure performed, HIV status, co-morbidities, nutritional status, haemoglobin, sensitivities and treatment.
Results.
Age ranged from 2 to 52 (mean 15.75 years) and included four males, six females, and four children. Of the thirteen patients who developed Surgical Site Infection (SSI), nine were posterior surgical wounds.
Two patients were HIV positive. Mean albumin and lymphocyte count was 34.88 and 2.37 respectively. The average wait to surgery was 23.8 hospital days, average length of ICU admission was 5.01 days. Signs of SSI developed at 11.75 days on average. Four cases showed sensitivity to Vancomycin, while ten were sensitive to Clindamycin. Patients were treated for a total of six weeks with antimicrobial therapy. Five patients required debridement, two required implant removal for chronic infection. Infection subsequently resolved in all patients.
Conclusion.
The risk factors were prolonged hospitalization, and posterior surgical wounds. Infection by community acquired MRSA was twice as common as nosocomial MRSA.
Current recommendations are to treat superficial sepsis with topical Mupirocin, while systemic antibiotics are reserved for patients at risk for MRSA bacteraemia and who have prosthetic implants. Screening for patient colonization is recommended when risk factors are present, while staff screening is recommended following outbreaks. The cornerstone in preventing MRSA infection is strict hand hygiene.
