MRSA Screening and Treatment in Children Undergoing Open Airway Surgery

A screening and antibiotic treatment regimen for methicillin-resistant Staphylococcus aureus (MRSA) in children undergoing open airway surgery may be helpful in minimizing MRSA-associated postoperative infections in these patients, according to a report published in the February issue of Archives of Otolaryngology Head & Neck Surgery.
MRSA infection in open airway procedures can be a devastating complication so the development and use of a screening and treatment antibiotic protocol is essential to proactively manage the care of this vulnerable population, the authors write in their study background. The aim of the study was to examine the use of such a protocol, which included antibiotics pre-, peri- and post-operatively.
The study by Melissa McCarty Statham, MD, of Emory University School of Medicine, Atlanta , and colleagues included 197 open airway operations in children from January 2007 to March 2009 at the Cincinnati Childrens Hospital Medical Center .
The authors found the overall prevalence of MRSA was 32.5 percent, but suggest this is largely attributable to the characteristics of the children they studied because a large percentage were premature and had other serious health problems. They note previous reports have suggested MRSA colonization may be greater in patients who are frequently hospitalized and who have had frequent exposure to antibiotics.
During the study period, there were no MRSA-associated postoperative infections in patients treated according to our antibiotic protocol, which is consistent with reported findings in other studies, the researchers comment. There also were no graft losses or dehiscence (the opening of a surgical wound) in patients who were MRSA-colonized.
Researchers note that three cases of postoperative MRSA infection occurred in patients who were previously MRSA negative, suggesting that MRSA was acquired during hospitalization. Two patients treated according to the protocol experienced graft loss or dehiscence associated with non-MRS infection.
In view of our results, we advise instituting MRSA screening and treatment protocols in patients undergoing airway surgery, the researchers conclude.

Reference: Arch Otolaryngol Head Neck Surg. 2012;138[2]:153-157.