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Staphylococcus aureus infections, one of the most common types of hospital-acquired infections, most frequently occur after two major surgical procedures, according to research from the Duke Infection Control Outreach Network (DICON).

“We found that chest and head procedures accounted for the majority of staph infections after major surgery,” said Deverick Anderson, MD, MPH, lead author of the study and an infectious diseases specialist at Duke University Medical Center and DICON.

Anderson and his team analyzed 81,267 patients who underwent 96,455 procedures at nine community hospitals and two tertiary care hospitals from 2003 to 2006. They looked at orthopaedic, neurosurgical, cardiothoracic, and plastic surgery procedures. The results are published online in the Infection Control and Hospital Epidemiology journal and will appear in the July print issue.

The research team identified 454 patients with S. aureus infections, 317 had surgical site infections and 188 had blood stream infections, meaning that 51 patients had both types of infections. The highest rates of blood stream infections occurred after cardiothoracic procedures and the highest rates of surgical site infections occurred after neurosurgical procedures.

“The key message is that one prevention strategy does not fit all,” Anderson said. “There may be additional preventions needed for cardiovascular or neurosurgical procedures that are not necessary for plastic or orthopaedic surgery.”

Strategies that focus solely on methicillin-resistant S. aureus (MRSA) will likely fail to prevent many infections, Anderson added. “On average MRSA was only present in half of the infections that we identified,” he said.

This study was funded by Merck & Co., Inc. The sponsor did not play a role in the analysis of the data.

Co-authors on the study include Yong Il Choi, Vance G. Fowler, Joelle Y. Friedman, Chelsea A. Grussemeyer, Chatelle Hardy, Shelby D. Reed, and Daniel J. Sexton, all of Duke; Jean Marie Arduino and Senaka A. Peter, of Merck Research Laboratories; and Keith S. Kaye of Wayne State University.