Risk factors associated with methicillin-resistant staphylococcal wound infection after spinal surgery

We used the data from a retrospective case controlled study to identify ris k factors for methicillin-resistant staphylococcal wound infection after sp inal surgery. Thirty-five cases and 35 uninfected control patients were mat ched for indication for initial surgery and approximate operative date. Pre operative, intraoperative, and postoperative risk factors were examined. At our institution between 1989 and 1995, 35 adult patients developed spinal wound infection requiring operative debridement; 16 infections were caused by methicillin-resistant staphylococci (MRS). Significant risk factors for MRS infection were lymphopenia, history of chronic infections, alcohol abus e, recent hospitalization, and prolonged postoperative wound drainage. Pati ents with MRS infections were also somewhat less likely to have received va ncomycin prophylaxis. In contrast, the only factor associated with infectio n caused by other pathogens was alcohol abuse. A number of preoperative ris k factors were significantly associated with subsequent MRS spinal wound in fection. Chemoprophylaxis with vancomycin should be targeted to patients at increased risk, because overuse may promote the emergence of vancomycin-re sistant pathogens.