Abstract:

Objective To observe the relationship between nasal colonization of Staphylococcus aureus (SA) and nosocomial infection after cardiac surgery, and investigate the efficacy of perioperative decolonization of nasopharynx with Anerdian Ⅲ. Methods Nasal bacterial cultures were performed by rubbing swabs at admission. Patients with SA colonization were randomly divided into decolonization group and control group. Patients in decolonization group were treated with Anerdian Ⅲ in nares, and those in control group were not. Nasal swabs were obtained and examined again on the third day after operation in both groups. The occurrence of postoperative nosocomial infection in all patients was observed, the relationship between nasal SA colonization and postoperative nosocomial infection was analysed, and the bacterial clearance rates and prevalences of postoperative nosocomial infection were compared between groups. Results A total of 363 patients were enrolled, and there was 37 patients (10.2%) with postoperative nosocomial infection. SA colonization rate at admission was 9.4%, and methicillin resistant Staphylococcus aureus (MRSA) was detected in 12 patients (3.3%). The prevalence of postoperative nosocomial infection in patients with MRSA (41.7%) was significantly higher than those in patients with the other bacterial colonization (P<0.05). The bacterial clearance rate in decolonization group was significantly higher than that in control group (77.8% vs 50%, P<0.05). In patients with MSRA, the prevalence of postoperative nosocomial infection in decolonization group was lower than that in control group, while there was no statistical significance due to limited cases. Conclusion The prevalence of postoperative nosocomial infection in patients with nasal MRSA colonization may increase. Decolonization with Anerdian Ⅲ may decrease the prevalence of postoperative nosocomial infection in MRSA carrier.

Key words: Staphylococcus aureus, methicillin resistant Staphylococcus aureus, colonization, cardiac surgery, nosocomial infection, decolonization, Anerdian