Methicillin-resistant Staphylococcus aureus Swab Results Did Not Change Treatment or Outcome in Pediatric Spinal Fusion Patients
Methicillin-resistant Staphylococcus aureus Swab Results Did Not Change Treatment or Outcome in Pediatric Spinal Fusion Patients
复制标题
耐甲氧西林金黄色葡萄球菌拭子结果没有改变小儿脊柱融合患者的治疗或结果
DOI：
10.5435/jaaos-d-17-00010
复制
发表时间：
2018
影响因子：
3.2
通讯作者：
D. Skaggs
中科院分区：
文献类型：
--
作者：
E. Nielsen;L. Andras;Liam R. Harris;D. Skaggs
前言：这项研究的目的是调查术前耐甲氧西林金黄色葡萄球菌(MRSA)拭子结果是否可以预测接受脊柱融合的儿童患者的手术部位感染(SSI)。方法：我们对2004-2014年间接受后路脊柱融合术的患者进行了回顾性图表回顾，以确定术前MRSA定植状态、SSI发生率和微生物。2012年10月1日之前，我们给患者应用万古霉素预防感染；从2012年10月1日开始，患者接受头孢他啶和Ancef(注射用头孢唑林；葛兰素史克)治疗。我们在所有的骨移植中加入了万古霉素粉末。结果：共有1200名患者符合纳入标准。在1,200例患者中，MRSA阳性28例(2.3%)，SSI发生率3.1%(37/1200)。MRSA拭子阳性和阴性患者的感染率差异无统计学意义(阳性拭子=1个SSI，阴性拭子=36个SSI；P=0.88)。3例SSI由MRSA引起。结论：术前鼻拭子MRSA检测结果与SSI发生率无相关性。证据级别：三级
Introduction: The aim of this study was to investigate whether preoperative methicillin-resistant Staphylococcus aureus (MRSA) swab results were predictive of surgical site infections (SSIs) in pediatric patients who have undergone spinal fusion. Methods: We conducted a retrospective chart review of patients who underwent posterior spinal fusion between 2004 and 2014 to determine preoperative MRSA colonization status and SSI rates and organisms. Before October 1, 2012, we administered vancomycin to the patients for infection prophylaxis; beginning October 1, 2012, patients received ceftazidime and Ancef (cefazolin for injection; GlaxoSmithKline). We added powdered vancomycin to all bone grafts. Results: A total of 1,200 patients met inclusion criteria. Of the patients, 2.3% (n = 28 of 1,200) were positive for MRSA, and an SSI developed in 3.1% (n = 37 of 1,200). No significant difference in infection rates was found between patients whose MRSA swab was positive and negative (positive swab = 1 SSI, negative swab = 36 SSIs; P = 0.88). Three SSIs were caused by MRSA. Conclusion: The results of a preoperative MRSA nasal swab had no correlation with SSI rates. Level of Evidence: Level III