Author(s)
Warren Swegal MD
Robert Deeb MD
Joshua Greene MD
Mary-Beth Perri
Marcus Zervos
Lamont Jones MD
Affiliation(s)
Henry Ford Health System
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to recognize the impacts of MRSA on postoperative infection rates during nasal surgery and understand that nasal surgery can affect major nasal colonizers, a novel finding. Objectives: In light of recent data demonstrating the nasal cavity as a potential reservoir for methicillin resistant staphylococcus aureus (MRSA) and increased surgical site infection rates, we sought to assess if MRSA colonization was a risk factor for postoperative infection in nasal surgery. In doing so, we also demonstrated for the first time how nasal surgery affects nasal colonization species. Study Design: Prospective cohort. Methods: Nasal swabs were obtained preoperatively and 1 week postoperatively in patients who had undergone functional and/or cosmetic nasal surgery from 2015 and 2016. Patient comorbidities and postoperative infections were assessed at 1 week and 1 month after surgery. Patients receiving prophylactic intraoperative or postoperative antibiotics were excluded. Results: A total of 86 patients were enrolled. Septoplasty was the most common procedure (51%). Six patients had diabetes (7.0%) and seven (8.1%) had prior nasal surgery. Only 2 patients (2.3%) had preoperative MRSA colonization while 11 patients had changes in their colonizing species from pre to postop. Two of the patients with changes in nasal flora become colonized with MRSA. A total of 5 patients (5.8%) had postoperative infections, none were MRSA related. Statistical analysis demonstrated prior nasal surgery was the only significant risk factor for postoperative infection. (p=0.21). Conclusions: Prior nasal surgery was the only significant risk factor associated with postoperative infection. MRSA carrier rate was minimal and MRSA carrier status was not associated with postoperative infection. Furthermore, nasal colonizers frequently change after nasal surgery, a novel finding, potentially changing risk for future infections.