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World Journal of Emergency Surgery
Published in: World Journal of Emergency Surgery 1/2016

Open Access 01-12-2016 | Review

Focus on the prophylaxis, epidemiology and therapy of methicillin-resistant Staphylococcus aureus surgical site infections and a position paper on associated risk factors: the perspective of an Italian group of surgeons

Authors: G. Sganga, C. Tascini, E. Sozio, M. Carlini, P. Chirletti, F. Cortese, R. Gattuso, P. Granone, C. Pempinello, M. Sartelli, S. Colizza

Published in: World Journal of Emergency Surgery | Issue 1/2016

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Abstract

Background

The aim of this research was to study the epidemiology, microbiology, prophylaxis, and antibiotic therapy of surgical site infections (SSIs), especially those caused by methicillin-resistant Staphylococcus aureus (MRSA), and identify the risk factors for these infections. In Italy SSIs occur in about 5 % of all surgical procedures. They are predominantly caused by staphylococci, and 30 % of them are diagnosed after discharge. In every surgical specialty there are specific procedures more associated with SSIs.

Methods

The authors conducted a systematic review of the literature on SSIs, especially MRSA infections, and used the Delphi method to identify risk factors for these resistant infections.

Results

Risk factors associated with MRSA SSIs identified by the Delphi method were: patients from long-term care facilities, recent hospitalization (within the preceding 30 days), Charlson score > 5 points, chronic obstructive pulmonary disease and thoracic surgery, antibiotic therapy with beta-lactams (especially cephalosporins and carbapenem) and/or quinolones in the preceding 30 days, age 75 years or older, current duration of hospitalization >16 days, and surgery with prothesis implantation. Protective factors were adequate antibiotic prophylaxis, laparoscopic surgery and the presence of an active, in-hospital surveillance program for the control of infections. MRSA therapy, especially with agents that enable the patient’s rapid discharge from hospital is described.

Conclusion

The prevention, identification and treatment of SSIs, especially those caused by MRSA, should be implemented in surgical units in order to improve clinical and economic outcomes.
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Metadata
Title
Focus on the prophylaxis, epidemiology and therapy of methicillin-resistant Staphylococcus aureus surgical site infections and a position paper on associated risk factors: the perspective of an Italian group of surgeons
Authors
G. Sganga
C. Tascini
E. Sozio
M. Carlini
P. Chirletti
F. Cortese
R. Gattuso
P. Granone
C. Pempinello
M. Sartelli
S. Colizza
Publication date
01-12-2016
Publisher
BioMed Central
Published in
World Journal of Emergency Surgery / Issue 1/2016
Electronic ISSN: 1749-7922
DOI
https://doi.org/10.1186/s13017-016-0086-1

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