What is the prevalence of MRSA colonization in elective spine cases? Spine

Background: The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing. However, the prevalence of MRSA colonization among patients undergoing spine surgery is unclear. Questions/purposes: We therefore (1) determined the prevalence of MRSA colonization in a population of patients scheduled for elective spine surgery; and (2) evaluated whether MRSA screening and treatment reduce the rate of early wound complications. Methods: We retrospectively reviewed prospectively collected data from 1002 patients undergoing elective spine surgery in 2010. There were 719 primary and 283 revision surgeries. Instrumentation was used in 72.0% cases and autologous iliac crest bone graft was taken in 65.1%. Twelve patients were lost to followup; of the remaining 990 patients, 503 were screened for MRSA and 487 were not. MRSA-colonized patients were treated with mupirocin and chlorhexidine. An early wound complication was defined as wound drainage or the presence of an abscess. Patients were followed for a minimum of 3 months (average, 7 months; range, 3-545 days). Results: Of the patients undergoing elective spine surgery and screened for MRSA, 14 of 503 (2.8%) were colonized with MRSA. The rates of early wound complications were similar for patients who were screened and pretreated for MRSA (17 of 503 [3.4%]) compared with those who were not (17 of 487 [3.5%]). Conclusions: The colonization rate for MRSA in our elective spine surgery population was comparable to that in the arthroplasty literature. Level of Evidence: Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.