Nelwan Erni J, Sinto Robert, Subekti Decy, Adiwinata Randy, Waslia Lia, Loho Tonny, Safari Dodi, Widodo Djoko
Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jl. Salemba Raya 6, Jakarta, 10430, Indonesia.
Eijkman Oxford Clinical Reseach Unit, Jl. Diponegoro No. 69, Jakarta, 10430, Indonesia.
BMC Res Notes. 2018 Jan 22;11(1):56. doi: 10.1186/s13104-018-3150-y.
Methicillin-resistant Staphylococcus aureus (MRSA) colonization is associated with serious surgical site infection in high-risk patients. High prevalence of MRSA colonization was reported in many settings, nonetheless local data is required. The purpose of this study is to identify the prevalence and risk factor of MRSA nasal carriage in adult patients in National Referral Hospital in Indonesia before underwent elective surgical procedure.
From 384 patients, 16.9% patients of them had undergone orthopaedic surgery, 51.3% had received antibiotics within the previous 3-month and 41.1% patients had history of hospitalization within the previous 1 year. Total of 21.6% patients were on invasive devices for at least 48 h before the operation; 24.2% had an open wound; 19.3% patients were referred from other hospital/ward. Of these patients, solid tumor without metastasis was the most common factor identified by the Charlson index (38.3%). Nasal colonization of Gram-positive bacteria was detected in 76.8%; S. aureus in 15.6% of patients (n = 60). MRSA was identified in three isolates (0.8%) by both culture and polymerase chain reaction (PCR) tests. Due to low prevalence of MRSA nasal carriage, this finding supports the recommendation to not routinely apply mupirocin for nasal decolonization on patient planned for surgery in Indonesia.
耐甲氧西林金黄色葡萄球菌（MRSA）定植与高危患者严重的手术部位感染相关。许多环境中都报告了MRSA定植的高患病率，但仍需要当地数据。本研究的目的是确定印度尼西亚国家转诊医院成年患者在接受择期手术前MRSA鼻腔携带的患病率和危险因素。
384例患者中，16.9%接受过骨科手术，51.3%在过去3个月内接受过抗生素治疗，41.1%的患者在过去1年内有住院史。共有21.6%的患者在手术前至少48小时使用侵入性设备；24.2%有开放性伤口；19.3%的患者从其他医院/病房转诊而来。在这些患者中，无转移的实体瘤是查尔森指数确定的最常见因素（38.3%）。76.8%的患者检测到革兰氏阳性菌鼻腔定植；15.6%的患者（n = 60）检测到金黄色葡萄球菌。通过培养和聚合酶链反应（PCR）检测，在三个分离株中鉴定出MRSA（0.8%）。由于MRSA鼻腔携带率较低，这一发现支持了在印度尼西亚不对计划手术的患者常规应用莫匹罗星进行鼻腔去定植的建议。
