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Rapid colonization with methicillin-resistant coagulase-negative staphylococci after surgery

Demartines, Nicolas
Imhof, Alexander
Senn, Gabriela
Ruef, Christian
Published in World Journal of Surgery. 2009, vol. 33, no. 10, p. 2058-2062
Collection Open Access - Licence nationale Springer
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.
Keywords Abdominal Wall/microbiologyAdultCoagulaseCohort StudiesDisinfectionElectrophoresis, Gel, Pulsed-FieldFemaleHumansMaleMethicillin-Resistant Staphylococcus aureus/*isolation & purificationMicrobial Sensitivity TestsMiddle AgedPreoperative CareProspective StudiesSkin/*microbiology/*surgeryStaphylococcal Skin Infections/*microbiologySurgical Procedures, ElectiveSurgical Procedures, Operative
PMID: 19672654
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ZINGG, Walter et al. Rapid colonization with methicillin-resistant coagulase-negative staphylococci after surgery. In: World Journal of Surgery, 2009, vol. 33, n° 10, p. 2058-2062. doi: 10.1007/s00268-009-0167-3 https://archive-ouverte.unige.ch/unige:20189

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Deposited on : 2012-04-23

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