Predictors of colonization with Staphylococcus species among patients scheduled for cardiac and orthopedic interventions at tertiary care hospitals in north-eastern Germany-a prevalence screening study

Eur J Clin Microbiol Infect Dis. 2018 Apr;37(4):633-641. doi: 10.1007/s10096-017-3154-x. Epub 2017 Dec 21.

Abstract

As methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in humans are a global challenge. In Mecklenburg and Western Pomerania (Germany) 1,517 patients who underwent surgical interventions were systematically screened for MRSA and MSSA colonization on the day of hospital admission and discharge. Demographic data, risk factors and colonization status of the (i) nose, (ii) throat, (iii) groin, and (iv) thorax or site of surgical intervention were determined. Of the 1,433 patients who were included for further evaluation, 331 (23.1%) were colonized with MSSA, while only 17 (1.2%) were MRSA carriers on the day of hospital admission. A combination of nose, throat and groin swabs returned a detection rate of 98.3% for MSSA/MRSA. Trauma patients had lower prevalence of MRSA/MSSA (OR 0.524, 95% CI: 0.37-0.75; p < 0.001) than patients with intended orthopedic interventions. Males showed significantly higher nasal S. aureus carrier rates than females (odds ratio (OR) = 1.478; 95% CI: 1.14-1.92; p = 0.003). Nasal S. aureus colonization was less frequent among male smokers as compared to non-smokers (chi2 = 16.801; phi = 0.154; p < 0.001). Age, gender and smoking had a significant influence on S. aureus colonization. Combining at least three different swabbing sites should be considered for standard screening procedure to determine S. aureus colonization at patients scheduled for cardiac or orthopedic interventions at tertiary care hospitals.

Keywords: Gender-related colonization; Methicillin-resistant Staphylococcus aureus; Methicillin-susceptible Staphylococcus aureus; Prevalence; Screening; Tertiary care hospitals.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Surgical Procedures* / adverse effects
  • Cardiac Surgical Procedures* / statistics & numerical data
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Cross-Sectional Studies
  • Female
  • Germany / epidemiology
  • Groin / microbiology
  • Humans
  • Male
  • Methicillin-Resistant Staphylococcus aureus*
  • Middle Aged
  • Nasal Cavity / microbiology
  • Orthopedic Procedures* / adverse effects
  • Orthopedic Procedures* / statistics & numerical data
  • Pharynx / microbiology
  • Prevalence
  • Risk Factors
  • Staphylococcal Infections / epidemiology*
  • Staphylococcal Infections / microbiology
  • Tertiary Care Centers
  • Young Adult