Objectives: (1) To determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in children undergoing open airway surgery using a screening protocol; (2) to examine the rates of postoperative infection in this cohort; and (3) to determine adherence to a MRSA antibiotic protocol.
Design: Retrospective cohort study.
Setting: Tertiary pediatric referral center.
Patients: The study population comprised 180 children undergoing 197 open airway operations from January 2007 to March 2009 at the Cincinnati Children's Hospital Medical Center.
Intervention: Methicillin-resistant Staphylococcus aureus screening and treatment protocol.
Main outcome measures: Prevalence of MRSA colonization, postoperative infection rates, colonization rates by site, and adherence to antibiotic protocol.
Results: A total of 180 patients who underwent 197 operations were included in the study. The overall prevalence of MRSA was 32.5%. There were no significant differences between MRSA-colonized and noncolonized patients regarding age at surgery, sex, gestational age at birth, or comorbidities. Postoperative infection rates were similar between the 2 groups (16% MRSA colonized; 17% MRSA noncolonized). Three patients who developed postoperative MRSA infections were MRSA negative on preoperative screening. Intraoperative adherence was high in both groups.
Conclusions: We describe a MRSA screening and treatment protocol for children undergoing open airway surgery. We found a high prevalence (32.5%) of MRSA colonization in these patients. Treatment of MRSA-colonized patients resulted in postoperative infection rates similar to those in MRSA-noncolonized patients. Treatment of MRSA-colonized patients resulted in no MRSA-associated postoperative infections, graft loss, or dehiscence. MRSA screening and treatment protocols may be helpful in minimizing MRSA-associated postoperative infections in these patients.