What Is the Prevalence of MRSA Colonization in Elective Spine Cases?

Abstract

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing. However, the prevalence of MRSA colonization among patients undergoing spine surgery is unclear. We therefore (1) determined the prevalence of MRSA colonization in a population of patients scheduled for elective spine surgery; and (2) evaluated whether MRSA screening and treatment reduce the rate of early wound complications. We retrospectively reviewed prospectively collected data from 1002 patients undergoing elective spine surgery in 2010. There were 719 primary and 283 revision surgeries. Instrumentation was used in 72.0% cases and autologous iliac crest bone graft was taken in 65.1%. Twelve patients were lost to followup; of the remaining 990 patients, 503 were screened for MRSA and 487 were not. MRSA-colonized patients were treated with mupirocin and chlorhexidine. An early wound complication was defined as wound drainage or the presence of an abscess. Patients were followed for a minimum of 3 months (average, 7 months; range, 3-545 days). Of the patients undergoing elective spine surgery and screened for MRSA, 14 of 503 (2.8%) were colonized with MRSA. The rates of early wound complications were similar for patients who were screened and pretreated for MRSA (17 of 503 [3.4%]) compared with those who were not (17 of 487 [3.5%]). The colonization rate for MRSA in our elective spine surgery population was comparable to that in the arthroplasty literature. Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.