Reduction in incidence of methicillin-resistant Staphylococcus aureus (MRSA) after radical surgery for head and neck cancer.

This study investigated factors associated with the onset of methicillin-resistant Staphylococcus aureus (MRSA) infection among patients with head and neck cancer who underwent radical reconstructive surgery. The study group consisted of 103 patients who underwent radical reconstructive surgery between January 1994 to December 2002. They were divided into two groups with respect to the date of surgery: Group I (from January 1994 to December 1997) and Group II (from January 1998 to December 2002). The use of third-generation cephalosporins and imipenem as postoperative antibiotics was restricted after 1998 (Group II). A significantly lower incidence of MRSA was found in Group II than for Group I (p = 0.0069, chi2 test). The following factors were identified as being associated with the onset of MRSA infection: long surgical duration (p < 0.035, Wilcoxon signed-rank test), large hemorrhage (p < 0.049, Wilcoxon signed-rank test), and use of third-generation cephalosporins or imipenem (p < 0.004, chi2 test). MRSA infection was found more often in the surgically reconstructed tongue and floor of the mouth. The use of antibiotics such as vancomycin, wound irrigation, curettage and sequestrectomy were effective in eradicating the infection. MRSA, when it occurred in the maxilla, was mostly limited to colonization.