MRSA Surgical Site Infections: What You Should Know

Imagine you, a friend, or a family member is about to have surgery. Maybe this time you’re having your ACL repaired, or your father is having a hip replaced, or your friend is having a C-section.

The surgery goes perfectly but then, seven days post-operation, the surgical site gets a little more painful. It isn’t healing and appears swollen. The pain increases, eventually persuading you, your father, or your friend to call the doctor. The doctor examines the surgical site and suspects that it has become infected.

In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. This statistic is much lower in high income countries such as the U.S., where the risk of developing an infection after surgery is about 1-3%.  However, with antimicrobial resistance on the rise, many infections are becoming more and more difficult to treat. MRSA, or methicillin-resistant Staphylococcus aureus, is a type of S. aureus that has become resistant to many first-line antibiotics and it commonly infects surgical wounds. The bacteria often enters the body through non-intact skin, such as when there are abrasions or incisions, and causes skin and soft tissue infections.

According to a recent report in The Lancet, Staphylococcus aureus  is among the six leading pathogens for deaths associated with resistance.. MRSA poses a serious threat to public health and safety given its association with significantly high morbidity and mortality.  The World Health Organization reports that patients with MRSA infections are 64% more likely to die than those with drug-sensitive infections.

Studies show that 1 in 3 people carry S. aureus in their nose and 2 in 100 carry MRSA in their nose. Generally, those who carry the bacteria in their nose do not become ill, but they may spread the organism to others and the message is clear—MRSA is common. MRSA in healthcare settings can lead to a number of severe issues including surgical site infections, blood stream infections, sepsis, and even death.

The degree of risk for a surgical site infection is related to the type of surgery and whether an infection is present at the time of surgery. The longer the surgery is, the older the patient, and whether or not the surgical site is already infected are contributing factors. Being overweight, smoking or having a weak immune system can also play a role.

Overall, MRSA infections in hospitalized patients are declining, but they can still be difficult to treat. MRSA infections are preventable and many lives have been saved through effective infection control interventions. However, MRSA is resistant to currently-available beta-lactam antibiotics, which includes penicillins, such as amoxicillin, “anti-staphylococcal” penicillins, such as methicillin, and cephalosporins.

You can help prevent a surgical site infection by asking your doctor what you can do to reduce your risk related to the type of surgery you are undergoing. Additionally, before the operation, your doctor may recommend that you avoid shaving the skin around the area where the surgery will take place. After the operation, follow all your doctor’s instructions carefully. Call your doctor if you develop a fever or notice pus, redness, or tenderness around the surgical site.

Opinions expressed in this article not necessarily those of bioMérieux.