RULING OUT MRSA BEFORE SURGERY

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Is there a role for preoperative nasal culture to rule out methicillin-resistant Staphylococcus aureus (MRSA) prior to surgery?
—Rajesh V. Dalal, MD, Lake Jackson, Tex.

Presently, the answer is no. There is lack of consensus on the appropriate use of preoperative screening for MRSA. This is due to the fact that although MRSA nasal carriage has been associated with poor surgical outcome in numerous observational studies, the eradication of MRSA has not been shown to be of significant clinical benefit. Despite initial enthusiasm stemming from some compelling clinical observations, more definitive randomized controlled trials have not supported this hypothesis. It appears that rigid attention to good hygiene remains the surgeon's best bet when it comes to reducing postoperative infectious complications.
—Cedric W. Spak, MD, MPH (115-12)

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