Looking Forward—Infection Prevention in 2016

Surgical sites identied as being at higher risk for postoperative S aureus infections. Based on the facilitys risk assessment, this may include patients known to be, or at risk for being, colonized with MRSA, those undergoing procedures involving implants (orthopedic or cardiac), or those who are otherwise at higher risk for postoperative infection. Preoperative MRSA/MSSA decolonization protocols are unique to each facility and are determined by each facility based on the manufacturers instructions for use but usually begin with a screening test to identify nasal colonization. After a patient has been identied as being positive for MRSA or MSSA colonization, the clinician should instruct the patient on how to complete a decolonization process during the week before surgery.This may include a schedule of skin cleansing with a chlorhexidine gluconate (CHG) antiseptic during a ve-day antimicrobial nasal treatment using intranasal mupirocin ointment.6 The entire process starting from collection of the nasal specimen to the conclusion of decolonization takes a minimum of six to seven days. The nasal screening specimen may be obtained at the time of presurgical testing in the surgeons or primary care physicians ofce or at an outpatient laboratory. The screening results typically are available within 24 hours for the polymerase chain reaction (PCR) test and within up to 72 hours for a culture-based test.