The prevalence of meticillin-resistant Staphylococcus aureus in long-term care facilities: is there a need for tailored glycopeptide prophylaxis?

Abstract

Prophylactic antibiotics are effective in reducing the rate of surgical site infection (SSI). Cephalosporin antibiotics are recommended except for patients colonised with meticillin resistant staphylococcus aureus (MRSA), where glycopeptide antibiotics are indicated. However, in the trauma setting, the MRSA status is unknown prior to surgery. Aim: To determine if the incidence of MRSA colonisation in trauma patients from long term care (LTC) warrants the use of empirical glycopeptide antibiotics. Methods: A retrospective analysis of patients admitted with hip fractures was performed. The MRSA status of patient from LTC facilities and home was determined. Results: The prevalence of MRSA colonisation in patients admitted from LTC facilities was 33.6%, compared to 3.6% for patients admitted from home, P < 0.001. Our results suggest that risk of patients carrying MRSA is significantly higher for patients being admitted form LTC. This group of patients may benefit from empirical glycopeptide antibiotic when the MRSA status is unknown.