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- W4234121567 abstract "Nasal swab culture is used to identify Staphylococcus aureus colonization, as this is a major risk factor for surgical site infection (SSI) in patients who are going to undergo major heart surgery (MHS). We determined nasal carriage of S. aureus in patients undergoing MHS by comparing the yield of a conventional culture with that of a rapid molecular test (Xpert® SA Nasal Complete, Cepheid). From July 2015 to April 2017, all patients who were to undergo MHS were invited to participate in the study. We obtained two nasal cultures from each patient just before entering the operating room, independently of a previous test for the determination of nasal colonization by this microorganism performed before surgery. One swab was used for conventional culture in the microbiology laboratory, and the other was used for the rapid molecular test. We defined nasal colonization as the presence of a positive culture for S. aureus using either of the two techniques. All patients were followed up until hospital discharge or death. Overall, 57 out of 200 patients (28.5%) were colonized by S. aureus at the time of surgery. Thirty-three patients had both conventional culture- and PCR-positive results. Twenty-four patients had a negative culture and a positive PCR test. Only twenty-one percent (12/57) of colonized patients had undergone an attempt to decolonise before the surgical intervention. A significant proportion of patients undergoing MHS are colonized by S. aureus in the nostrils on entering the operating room. New strategies to prevent SSI by this microorganism are needed. Rapid molecular tests immediately before MHS, followed by immediate decolonisation, must be evaluated. Trial Registration Clinical Trials.gov NCT02640001. Los cultivos nasales se usan para identificar colonización por Staphylococcus aureus, ya que la colonización es un factor de riesgo para la infección de la herida quirúrgica en pacientes que van a ser sometidos a cirugía cardiaca mayor (CCM). En este trabajo, identificamos portadores de S. aureus en el momento quirúrgico en pacientes que van a ser sometidos a CCM, comparando el resultado del cultivo convencional con un test molecular rápido (Xpert® SA Nasal Complete, Cepheid). Desde julio del 2015 hasta abril del 2017, a todos los pacientes que iban a ser intervenidos con CCM se les invitó a participar en el estudio. Se obtuvieron 2 cultivos nasales de cada paciente, justo antes de entrar en el quirófano, independientemente de si había un test previo de colonización nasal realizada. Una torunda fue usada en el laboratorio de microbiología para cultivo convencional y la otra para el test molecular rápido. Se definió colonización nasal como la positividad para S. aureus por cualquiera de las 2 técnicas. Todos los pacientes fueron seguidos hasta el alta hospitalaria o éxitus. Un total de 57 de 200 pacientes (28,5%), estaban colonizados por S. aureus en el momento de la cirugía. En total, 33 pacientes tuvieron ambas muestras positivas (convencional y PCR); 24 pacientes tuvieron cultivo negativo y PCR positiva. Solo el 21% (12/57) de los pacientes colonizados habían tenido un intento de descolonización antes de la cirugía. Un porcentaje alto de pacientes están colonizados por S. aureus en el momento de ser sometidos a CCM. Son necesarias nuevas estrategias para prevenir la infección de la herida quirúrgica por este microorganismo. Un test molecular rápido inmediatamente antes de la CCM y descolonización posterior inmediata debe ser evaluado. Trial Registration Clinical Trials.gov NCT02640001." @default.
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- W4234121567 date "2020-12-01" @default.
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- W4234121567 title "Colonization of the nasal airways by Staphylococcus aureus on admission to a major heart surgery operating room: A real-world experience" @default.
- W4234121567 doi "https://doi.org/10.1016/j.eimce.2019.07.010" @default.
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