Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon 29239, USA.
Laryngoscope. 2010 Jul;120(7):1309-11. doi: 10.1002/lary.20966.
Review the literature on methicillin-resistant Staphylococcus aureus (MRSA) infection following septorhinoplasty, identify patient groups at risk for MRSA complications following septorhinoplasty, and evaluate the need for antibiotic prophylaxis in these patients.
Patients who are susceptible to MRSA infections may also be at higher risk for nasal colonization, and this includes elderly patients, patients recently hospitalized or treated in a rehabilitation center, and healthcare workers. Few cases of MRSA infection following septorhinoplasty have been reported in the literature. Prevention of nosocomial and postsurgical MRSA infections has been well studied, and it seems that elimination of nasal colonization is a major step in preventing these infections.
Patients at increased risk for MRSA colonization should be screened prior to septorhinoplasty and if positive treated with antibiotic prophylaxis consisting of elimination of nasal carriage prior to surgery. Perioperative systemic antibiotic use should be considered, especially in revision cases.
回顾鼻中隔成形术后耐甲氧西林金黄色葡萄球菌(MRSA)感染的文献,确定鼻中隔成形术后发生 MRSA 并发症的高危患者人群,并评估这些患者使用抗生素预防的必要性。
易感染 MRSA 的患者也可能有更高的鼻腔定植风险,包括老年患者、最近住院或在康复中心治疗的患者以及医护人员。文献中报告的鼻中隔成形术后 MRSA 感染病例很少。针对医院内和手术后 MRSA 感染的预防已得到充分研究,似乎消除鼻腔定植是预防这些感染的重要步骤。
应在鼻中隔成形术前对有发生 MRSA 定植风险的患者进行筛查,如果阳性,应在手术前使用抗生素预防治疗,包括消除鼻腔携带。应考虑围手术期全身使用抗生素,尤其是在翻修病例中。