Methicillin-resistant Staphylococcus aureus (MRSA) infection in lower extremity amputations – a gigantic health-care problem or a false alarm?

  • Muhammad Asad Parvaiz Department of General Surgery, New Cross Hospital, Wolverhampton, West Midlands, WV10 0QP, UK
  • Muhammad Ahad Pervaiz Department of General Surgery, King Edward Medical University, Mayo hospital, Lahore, Pakistan
Keywords: MRSA, Staphylococcus aureus, Amputation, Infection, Morbidity

Abstract

Objectives:  Methicillin-resistant Staphylococcus aureus (MRSA) poses not only an increasingly serious health-care problem but also a notoriously gigantic public issue.  We aimed to evaluate whether MRSA infection is a significant negative predictive factor for amputation healing and morbidity, in comparison to non-MRSA infections.

Materials and Methods:  A cross-sectional comparative study of all the lower extremity amputations during the 25-month study period to examine the influence of MRSA and non-MRSA infection on clinical outcome.  Results were compared between MRSA- and non-MRSA-infected patients using Fisher’s exact test.

Results:  During the two-year period, 171 patients underwent lower limb amputations for acute or chronic limb ischemia.  Sixteen (9.3%) had documented wound infection; including 10 MRSA (62.5%), 2 methicillin-sensitive Staphylococcus aureus (12.5%), 2 Pseudomonas aeruginosa (12.5%), 1 coagulase-negative staphylococci (6.2%) and 1 enterococcus (6.2%).  Patients with MRSA and non-MRSA infections were well matched in demographics, indication & level of amputation, duration of operation, American Society of Anesthetists (ASA) grades, and wound classification (p<0.05).   

There was no death or morbidity observed within 30 day post-operative period in all groups within the study.  Over a 28 months median follow-up (range 16-50 months), an overall survival of 93% was observed.  Twelve patients (7%) died including one in MRSA group and 11 in no infection group. 

Conclusion:  MRSA infection does not adversely affect the clinical outcome in patients undergoing lower extremity amputations.  Regardless of presence of MRSA bacteria; common infection control measures, thorough wound debridement, careful wound surveillance and judicial administration of antibiotics should be routinely applied to all patients.

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Published
2015-10-11
How to Cite
1.
Parvaiz MA, Pervaiz MA. Methicillin-resistant Staphylococcus aureus (MRSA) infection in lower extremity amputations – a gigantic health-care problem or a false alarm?. AMS [Internet]. 11Oct.2015 [cited 21Feb.2020];2(7):112-5. Available from: http://asdpub.com/index.php/ams/article/view/253
Section
Original Articles

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