New methods of control against postoperative methicillin-resistant Staphylococcus aureus infection

The incidence of postoperative infections caused by methicillin-resistant S taphylococcus aureus (MRSA) in Japan has been increasing dramatically. In M arch 1990, we assigned special doctors in infection control (infection cont rol doctor, ICD), and defined comprehensive controls against MRSA infection . A total of 3536 cases of digestive tract surgery performed at our departm ent were studied during the period between September 1987 and August 1997. We changed the use of antibiotics to prevent post operative infection. Cefa zolin (CEZ) was employed for surgery of the upper digestive tract, includin g esophagus, stomach, duodenum, and gallbladder. Cefotiam (CTM) was employe d for surgery of the lower digestive tract, liver, and pancreas. In esophag eal resection, the tracheal tube was extracted during the early postoperati ve period, and for cervical esophagogastroanastomosis, the autosuture was c hanged to layer-to-layer anastomosis. We have achieved successful control o f postoperative MRSA infection, the incidence having decreased to 0.3% (9/2 703). In conclusion, our methods of control against postoperative MRSA infe ction implies that comprehensive measures of prevention, including the revi ewed specification and usage of antibiotics and operation management, have been well implemented. This value is the lowest and the first of any domest ic hospital or institute in Japan, suggesting a continued and significant d ecrease.