Postoperative complications caused by infection with methicillin-resistant strains of Staphylococcus aureus (MRSA) are a serious problem in cardio-thoracic surgery. According to researchers at Rochester Hospital (United Kingdom), from 2004 to 2007, a high incidence of post-operative wound infections caused by MRSA was observed in hospital after cardiothoracic surgical procedures. The proportion of MRSA among all pathogens of surgical infection (IOS) during this period was steadily increasing to 54%.

In this context, a comprehensive program of special measures to prevent MRSA infections has been introduced in the hospital. The program included screening all incoming patients for MRSA; intranasal administration of mupirocin to all hospitalized patients to prevent colonization of MRSA; patients with confirmed MRSA colonization also received perioperative prophylaxis with vancomycin.

Following the introduction of this program in the hospital, there was a rapid and significant decrease in the frequency of ICRIs caused by MRSA. Thus, for the 3-year period preceding the introduction of this program, 32 cases of IOSC caused by MRSA were recorded in 2767 hospitalizations, while after its introduction, only 2 cases of infection with MRSA were recorded in 2496 hospitalizations (risk ratio - RR = 0.069; p less than 0.001), which indicates a decrease in the frequency of MRSA infections postoperative in hospital by 93%. In addition, the total frequency of IOI in the hospital went from 2.1% to 0.8% (59 IOI in 2769 hospitalizations vs 20 IOI in 2496 hospitalizations; p less than 0.001).

Thus, the experience of this hospital indicates the possibility of a significant reduction in the incidence of postoperative infectious complications due to MRSA in cardiothoracic surgery due to the introduction of a comprehensive program of measures to prevent such infections.

An important feature of this program is that it not only targets the identification and rehabilitation of MRSA carriers among patients admitted to hospital, but also includes the prophylactic use of mupirocin in all hospitalized patients, regardless either the carrier of MRSA. This helps prevent colonization of MRSA patients during hospitalization and greatly reduces the risk of ICRI caused by this pathogen. The introduction of this program in the hospital not only significantly reduced the incidence of postoperative infectious complications caused by MRSA in patients undergoing cardiothoracic surgery, but also resulted in a significant reduction in patient management costs.