Surgical site infection among patients with Staphylococcus aureus nasal carriage

Background: Staphylococcus aureus (SA) is an invasive bacterium that may lead to both hospital and community acquired infection. SA may reside in the nose and may act as an endogenous source of surgical site infection (SSI). The emergence of resistant strains of SA complicates infection. Objectives: In this study we studied the relation between surgical site infection and nasal carriage of Staphylococcus Aureus . Methods: This is a prospective study that was done in the surgical words in two surgical centers in Duhok city. A total number of 257 patients were included in this study. Nasal swabs were taken from patients who underwent various surgical procedures, and were sent for bacteriological examination to detect the staphylococcal carriage status for each patient. Results: Clean surgeries were the commonest (61.1%) and elective surgeries comprised (92.2%). About 38% were nasal carriers for SA and 18.7% developed SSI. The most common bacteria isolated form infected wounds were Klebsiella (3.9%), in 7% no bacteria were cultured despite the signs of infection. We detected a significant correlation between wound infection and the duration of the hospital stay (P value 0.030), and with some types of operations such as hernias, hepatobiliary-pancreatic, and upper gastrointestinal tract surgeries (P values 0.017, 0.024, and 0.049) respectively. Conclusion: There is no increased incidence of SSI in nasal carriers of SA. Treatment of nasal carrier with topical bactericidal agent is still recommended in high risk patient, but extended use of antibiotics is not required. Guidelines should be followed to reduce SSI and the duration of hospital stay should be reduced to minimum. Highlights: