Purpose: The aim of this study was to assess the incidence of methicillin-resistant Staphylococcus aureus (MRSA) colonisation in patients admitted into a level 1 German trauma centre with proximal femur fractures, to correlate this incidence with defined risk factors for MRSA colonisation and to determine its influence on morbidity and mortality.
Methods: Between August and November 2006, 65 patients were included in the study. Cotton-tipped swab samples were taken from the nose, throat, groin and any skin defects in the emergency room. The following factors were recorded: age, gender, any concomitant diseases, the fracture type and treatment device, skin lesions, hospitalisation within the last year, any urinary or vascular catheters, a nasogastric or gastrostomy tube, an ileal stoma, the use of a respirator and antibiotic therapy within the last year. During follow-up, data concerning any surgical site infections; any chest, urinary or vascular catheter infections; the success of decontamination and death within 1 year after surgery were collected.
Results: The risk factors for MRSA colonisation were positive in 40 patients. The incidence of MRSA colonisation was 17%, which is higher than in most comparable studies but consistent with some very recent publications. The nosocomial infection rates, surgical site infection rates and mortality within the 1-year follow-up period were significantly higher in the MRSA-colonised patients.
Conclusion: The high incidence of MRSA in this study supports the need for systematic detection of MRSA-colonised patients. In our hospital, any patient with positive risk factors for MRSA colonisation is swabbed in the emergency room and treated as MRSA positive until proven otherwise.