The Yin and Yang of pre-operative screening for meticillin resistant and sensitive Staphylococcus aureus (MRSA and MSSA): Does the extra effort and cost of suppression reduce surgical site infections?

The inappropriate use and overuse of antibiotics, together with the demographic changes of an ageing population, chronic diseases such as diabetes mellitus, increased patient contact with healthcare facilities, high bed occupancy rates and the increase in surgical procedures, have all contributed to the rise in prevalence of Healthcare Associated Infections. These are attributable to selection and emergence of multi-resistant organisms. Additionally, there is evidence that this surveillance programme considerably underestimates true rates of SSI.

Strategies for prevention of SSIs are still in development and both MSSA and MRSA surveillance/suppression are likely to be considered as a plausible strategy for identifying at-risk patient prior to surgery, but a pertinent question remains: which surgical patients are likely to benefit most from this intervention?