Patients scheduled for surgery often undergo screening for Methicillin-resistant Staphylococcus aureus (MRSA) as a safety measure. This article provides clarity on why this screening is performed and what patients can typically expect regarding the timing and procedure of the MRSA swab.
Understanding MRSA
MRSA is a type of Staphylococcus aureus bacteria that has developed resistance to several common antibiotics, including methicillin and related drugs. Many individuals can carry MRSA harmlessly on their skin or in their nose without experiencing any symptoms, known as colonization. While colonization typically does not cause illness, MRSA can lead to serious infections if it enters the body through a wound, surgical incision, or medical device. This is particularly relevant in healthcare settings, where patients are more vulnerable.
Purpose of Pre-Surgical Screening
Hospitals screen patients for MRSA before surgery to identify those colonized with the bacteria. This proactive approach aims to prevent surgical site infections (SSIs), a serious complication following an operation. By knowing a patient’s MRSA status, healthcare providers can implement specific measures to reduce bacteria on the patient’s body, lowering the risk of infection during and after the procedure. Such screening also helps prevent the spread of MRSA to other patients within the hospital, allowing for tailored infection control strategies.
Timing and Process of the MRSA Swab
The MRSA swab is typically performed as part of a patient’s pre-operative assessment. While exact timing can vary, it is often done within a few days to a week or two before the scheduled surgery. Some guidelines suggest screening at least one week prior to admission for elective procedures to allow ample time for results and potential decolonization. The process is simple and non-invasive, usually involving a healthcare professional taking a sample with a cotton swab.
The most common sites for swabbing include the inside of both nostrils, but samples may also be taken from the throat, armpit, groin, or any existing wounds or device entry sites. The swab is sent to a laboratory for testing. Results are typically available within three to five days; rapid tests can provide results sooner. This timeframe allows medical teams to prepare and initiate interventions if MRSA is detected.
Managing a Positive MRSA Result
If a patient tests positive for MRSA before surgery, a plan is implemented to reduce bacterial load and minimize infection risk. This often involves a decolonization protocol, including special antiseptic washes like chlorhexidine gluconate (CHG), for several days before surgery. Patients may also be prescribed a nasal ointment, such as mupirocin, for application inside their nostrils. These treatments aim to reduce MRSA on the skin and in the nose.
A positive MRSA result does not automatically mean surgery is canceled. In some cases, surgery might be delayed to allow decolonization treatment to be fully effective. During surgery, additional precautions, such as specific antibiotics like vancomycin, may be administered to MRSA-positive patients. Hospitals also implement enhanced infection control measures for MRSA-positive patients to prevent transmission. The healthcare team communicates the specific plan and provides instructions to ensure a safe surgical outcome.