St. Mark's Hospital - May 11, 2017

The safety of our patients depends, in part, on our ability to identify staphylococcus aureus colonization and address it prior to surgery.

In order to better identify patients colonized with methicillin - sensitive staphylococcus aureus (MSSA) for the purpose of preventing MSSA surgical site infections, MSSA testing will be added to our existing routine nasal swab screening for methicillin - resistant staphylococcus aureus (MRSA) for all patients undergoing cardiothoracic surgery, or surgery involving spine hardware, joint prostheses, or other implanted materials. The presence of MSSA will trigger the same prophylactic regimen as does the presence of MRSA, which includes nasal mupiricin (Bactroban) and chlorhexidine body washes pre-operatively and daily for 14 days prior to elective surgery. For patients requiring urgent/emergent surgery, 4% chlorhexidine body washes (or wipes) prior to surgery should be considered. If only part of the 14-day treatment can be accomplished prior to surgery, the remainder should be accomplished post-operatively.

The presence of MRSA is considered to be a “critical value” requiring notification of the ordering practitioner. The presence of MSSA is NOT considered to be a critical value, so no special practitioner notification will be made.

BioFire lab technology will be used for this screening. The laboratory turnaround time approximates 90 minutes, so physicians are advised to order this screening well in advance of scheduled surgery time to allow the results to drive appropriate pre-operative action.

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