Preventing MRSA infections in pediatric airway surgery through preoperative screening
With Dr. Alessandro de Alarcon · hosted by Dr. Jan Engmeyer
Chapter 1 of 4
MRSA colonization
Introduction and MRSA colonization definition
Expert statements on this page
No expert statements were drawn from this page.
Host summaries · secondary, not cited in answers
Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
Podcast
Combined cervical and thoracic approach for esophageal atresia with tracheopexy
Alessandro de Alarcon · 5 min · Published Dec 2023
Video
QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon
Dr. Todd Ponsky · 5 min · Published Dec 2023
Video
Inside Tract: Bilateral Vocal Fold Paralysis | Cincinnati Children's
Alessandro de Alarcon · Published Mar 2020
Podcast
Screening and treatment of MRSA colonization in pediatric airway surgery patients
Alessandro de Alarcon · 8 min · Published Feb 2012
What the experts said
MRSA (methicillin-resistant Staphylococcus aureus) can cause serious infections in skin and surgical wound sites.
Studies in the last decade show an increasing number of MRSA infections both in the community and during surgical procedures globally.
The increase in resistant bacterial strains is thought to be due to more frequent antibiotic use than in the past.
At Cincinnati Children's, a series of patients had severe MRSA infections that led to failure of their airway reconstruction.
The Cincinnati protocol screens patients for MRSA prior to airway surgery and treats colonized patients with antibiotics before and during surgery to prevent surgical site infections.
MRSA colonization means patients have the bacteria growing in their skin or some body site but it is not causing an infection.
Studies show MRSA surgical site infections increase hospital admission costs by up to approximately $62,000.
MRSA infections can cause rib grafts used in airway reconstructions to die, leading to complete operation failure.
A typical airway reconstruction runs around $90,000 in hospital charges or costs.
Children undergoing airway reconstruction may be in the hospital from anywhere from a couple of weeks to about a month.
Surgical site infections have historically been looked at as an accident or something that's not preventable.
About one-third of children with tracheostomies screened at Cincinnati Children's are colonized with MRSA.
Other surgical practices that have published papers about screening and treatment programs typically consider high-risk patient populations as having 8 to 10% MRSA colonization.
Children with tracheostomies undergoing airway reconstruction are a high-risk patient population that commonly are colonized with MRSA.
The study design could not prove that the Cincinnati protocol is the perfect protocol.
Places doing a lot of airway reconstruction should have a clinical protocol in place for screening before surgery and treatment of MRSA colonization.
The study showed there was not any increase in MRSA infections in patients that were MRSA positive who received treatment under the protocol.