A Computer Model to Screen Cardiac Surgery Patients for MRSA

July 25, 2010

A computer model shows that preoperative MRSA screening of cardiac surgery patients provides economic value to third-party payers and hospitals.

This article originally appeared in the American Journal of Managed Care, a member of the HCPLive network.

Infection due to Staphylococcus aureus is a common complication of cardiac surgical procedures. Postoperative S aureus infections have been associated with significant morbidity, prolonged hospitalization, higher medical costs, an increased likelihood of readmission within 90 days postprocedure, and death. S aureus is the most common cause of sternal wound infections and the leading cause of infective endocarditis in the developed world. An increasing number of these infections are due to methicillin-resistant S aureus (MRSA), resulting in greater morbidity and mortality than infections from methicillin- sensitive S aureus (MSSA) strains.

Patients about to undergo cardiac surgery tend to have a number of factors predisposing them to postoperative MRSA infections, including older age, comorbid conditions (eg, congestive heart failure, chronic kidney disease, diabetes), and recent hospitalization. An estimated 30% of Americans are chronic or intermittent carriers of S aureus and nasal MRSA colonization rates from 0.4% to 20.6% have been reported. Cardiac surgery procedures often are invasive, involving prolonged use of mechanical support devices and indwelling intravenous lines, and introduce foreign materials and tissues (eg, a pacemaker, a prosthetic valve) into the body.

Preoperative screening and decolonization of cardiac surgery patients who are MRSA positive could help prevent postoperative MRSA infections and their sequelae.

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