Einflussfaktoren für die Kolonisation bzw. Infektion durch MRSA bei Patienten einer Klinik für Allgemein-, Viszeral-, Gefäß- und Thoraxchirurgie

Method: Patients with MRSA colonization or infection at the Clinic for Gerneral-, Visceral-, Thoracic- and Vascular Surgery at the Dietrich – Bonhoeffer – Klinikum Neubrandenburg between 2014 and 2016 were examined. The following data were collected from the digital patient files and evaluated with the help of SPSS: Type of surgical intervention, comorbidities, operating times, antibiosis in the inpatient stay, stay in an intensive care unit, if necessary duration of ventilation and use of invasive catheters. In the evaluation, patients with an MRSA infection were compared to the patients with a colonization. Results: A total of 159 patients with MRSA could be detected (2014: 49, 2015: 50, 2016: 60), of which a colonization was found in 114 patients (71.7 percent). Two thirds oft he patients were male (66.1 percent), the mean age was 65 years. Nosocomial but also community – acquired MRSA infections show longer operation times, more post – operative wound infectionsand more frequent stays in an intensive care unit with long ventilation times. The pathogen was detected in 76 percent of infected patients from blood cultures. Further evidence came from wounds, tracheal secretion oder punctates. Compared with the other surgical patients in the observation period, the patients with an MRSA infection had a statistical significant increased number of comorbidities such as diabetes mellitus, cardiac and neurological diseases. In patients with colonization, there were also more comorbidities, but without statistical significance. The rate of germ remediation for nosocomially acquired infections or colonizations was 74 percent. The mortality from MRSA infection was statistical not significantly increased during the observation period. Discussion: The results confirm that colonization or infection with MRSA is associated with diabetes mellitus, cardiac and neurological diseases and that the type of surgical intervention, the duration of the operation and the supply of invasive catheters are associated with postoperative morbidity. For this reason, preoperative screening for MRSA and germ remediation is recommended if risk factors were detected. This will result in more effective protection of patients and medical staff while also saving costs. The use of antibiotics used must also be viewed critically.