MRSA Infection in Vascular Surgical Patients: The HKL Experience
MRSA Infection in Vascular Surgical Patients
Abstract
Methicillin-resistant Staphylococcus aureus (MRSA) infection is important among vascular surgical patients. Its effect can be devastating resulting in limb amputation and mortality. We performed a retrospective patients record analysis to determine the pattern of MRSA infection among vascular surgical patients in Hospital Kuala Lumpur from January 2005 to December 2007. We also attempted to identify the factors associated with poor clinical outcome after such infection. There were 999 patients who underwent vascular surgeries in HKL within the analysis period. Of these 24 patients (2.4%) were detected to have MRSA surgical site infection. The infection was commoner among cigarette smokers, patients with diabetes melitus and those who had previous vascular surgery. Most infections occurred in the emergency surgery category and manifested as wound breakdown. Fifty-four percent of the infected patients ended with graft removal, amputations or death. MRSA infection complicating vascular surgery resulted in poor clinical outcome. This serious threat requires intensified preventive measures.
Keywords :
MRSA infection,
vascular surgery,
Abstrak
Jangkitan Methicillin-resistant Staphylococcus aureus (MRSA) kerap berlaku di kalangan pesakit yang menjalani pembedahan vaskular. Ianya boleh mengakibatkan kehilangan anggota atau kematian. Kami melaksanakan analisa retrospektif terhadap nota pesakit pembedahan vaskular di Hospital Kuala Lumpur untuk tempoh 2 tahun mulai Januari 2005 hingga Disember 2007. Ianya bertujuan mengamati corak jangkitan dan faktor-faktor yang mengakibatkan jangkitan ini. Seramai 999 pesakit menjalani pembedahan vaskular dalam rangkuman jangkamasa kajian ini. Dari jumlah ini, seramai 24 pesakit (2.4%) dikesan terjangkit oleh MRSA. Jangkitan ini didapati terjurus kepada pesakit yang merokok, pesakit diabetes melitus dan mereka yang terdahulunya pernah menjalani pembedahan vaskular. Kebanyakan jangkitan bercorak kemusnahan terhadap luka pembedahan dan berlaku dalam kategori pembedahan kecemasan. Sebanyak 54% dari kes jangkitan berakhir dengan kehilangan anggota atau pengeluaran graf vaskular atau kematian. Jangkitan MRSA mengakibatkan kesan klinikal yang buruk terhadap pesakit yang menjalani pembedahan vaskular. Langkah pencegahan yang intensif diperlukan bagi mengelakkan kesan buruk yang tidak diingini ini.
Kata Kunci :
jangkitan MRSA,
pembedahan vaskular,
Correspondance Address
Associate Professor Dr. Ismail Sagap, Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur.
Email: drisagap @mail.hukm.ukm.my
