Original Article

Pediatric Surgery International

, Volume 30, Issue 5, pp 521-525

First online:

Does Staphylococcus aureus nasal carriage require eradication prior to elective ambulatory surgery in children?

  • Zvi SteinerAffiliated withDepartment of Pediatric Surgery B, Hillel Yaffe Medical Center
  • , Orna Ben NatanAffiliated withDepartment of Epidemiology, Hillel Yaffe Medical Center
  • , Igor SukhotnikAffiliated withDepartment of Pediatric Surgery, Bnai Zion Medical Center Affiliated with the Rappaport Faculty of Medicine, The Technion Email author 
  • , Arnold G. CoranAffiliated withSection of Pediatric Surgery, C.S. Mott Children’s Hospital and University of Michigan Medical School
  • , Gershon KerenAffiliated withDepartment of Infectious Disease, Hillel Yaffe Medical Center

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Abstract

Purpose

Rates of community-associated Staphylococcus aureus, and particularly of methicillin-resistant Staphylococcus aureus (MRSA) in children, have increased in recent years. We investigated rates of nasal colonization of S. aureus, and a possible correlation between nasal carriage and wound infection.

Methods

A prospective study of children scheduled for elective day-care surgical procedures between January 2008 and December 2012 at one medical center. Nasal swabs were taken before surgery, and follow-up was performed 1–2 weeks following surgery.

Results

Of 1,127 children (median age 2 years, 70.6 % males), positive nasal swabs were detected in 228 (20.2 %). Rates of S. aureus nasal carriage were lowest for ages 6 months to 2 years and highest for ages 4–11 years. Child’s sex did not associate with the risk for positive nasal swabs. Positive nasal swabs for MRSA were detected in five boys (0.62 % of the population). Five children (0.44 %) had wound infection. None of them was a nasal carrier.

Conclusions

No correlation was observed between positive nasal swabs and wound infection in children who were candidates for elective ambulatory operations. This suggests that evaluation of S. aureus nasal carriage and eradication may not be necessary in this population.

Keywords

Methicillin resistant Staphylococcus aureus (MRSA) Methicillin sensitive Staphylococcus aureus (MSSA) Community-associated infections Nasal swab Surgical wound Nasal colonization