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Rapid Colonization with Methicillin-Resistant Coagulase-Negative Staphylococci After Surgery

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Abstract

Background

Antimicrobial resistance may compromise the efficacy of antibiotic prophylaxis before surgery. The aim of this study was to measure susceptibility and clonal distribution of coagulase-negative staphylococci (CoNS) colonizing the skin around the surgery access site before and after the procedure.

Methods

From March to September 2004, a series of 140 patients undergoing elective major abdominal surgery were screened for CoNS colonization at admission and 5 days after surgery. All isolates were tested for antibiotic susceptibility and genotyped by pulsed-field gel electrophoresis (PFGE).

Results

Colonization rates with CoNS at admission and after surgery were 85% and 55%, respectively. The methicillin-resistant CoNS rate increased from 20% at admission to 47% after surgery (P = 0.001). The PFGE pattern after surgery revealed more patients colonized with identical clones: 8/140 patients (8/119 strains) and 26/140 patients (26/77 strains), respectively (P < 0.001).

Conclusions

Our results suggest rapid recolonization of disinfected skin by resistant nosocomial CoNS. Larger studies, preferably among orthopedic or cardiovascular patients, are required to clarify whether standard antibiotic prophylaxis with first- or second-generation cephalosporins for CoNS infections may be compromised if the patient requires an additional intervention 5 days or more after the initial surgery.

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Acknowledgments

We thank the members of the Clinic of Visceral Surgery and the operating teams of the Department of Surgery of the University Hospital of Zurich for their contribution. The study was supported by an unrestricted research grant from GlaxoSmithKline, Switzerland.

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Authors and Affiliations

  1. Division of Infectious Diseases and Hospital Epidemiology, Department of Medicine, University Hospital of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland

    Walter Zingg, Alexander Imhof, Gabriela Senn & Christian Ruef

  2. Infection Control Programme, University of Geneva Hospitals, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland

    Walter Zingg

  3. Clinic of Visceral Surgery, Department of Surgery, University Hospital of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland

    Nicolas Demartines

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  1. Walter Zingg
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  2. Nicolas Demartines
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  3. Alexander Imhof
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  4. Gabriela Senn
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  5. Christian Ruef
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Correspondence to Walter Zingg.

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Zingg, W., Demartines, N., Imhof, A. et al. Rapid Colonization with Methicillin-Resistant Coagulase-Negative Staphylococci After Surgery. World J Surg 33, 2058–2062 (2009). https://doi.org/10.1007/s00268-009-0167-3

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