Authors: Haq, A.I.; Cook, L.J.

Source: Annals of The Royal College of Surgeons of England, Volume 89, Number 3, April 2007 , pp. 303-308(6)

Publisher: The Royal College of Surgeons of England

Abstract:

INTRODUCTION: Nosocomial MRSA infection has become an important healthcare issue. We present 6 cases of MRSA enteritis, acquired following bowel surgery and ileostomy formation.

PATIENTS AND METHODS: The data set was obtained from the experience of one consultant surgeon over 6 years in one medical centre. The clinical features and course of six patients that developed MRSA enteritis postoperatively were obtained through review of case notes and laboratory data.

RESULTS: Four male and two female patients (age range, 22-80 years) developed a clinical syndrome postoperatively requiring treatment within the high dependency unit. Three developed respiratory distress syndrome, and one died from multi-organ failure. Exploratory laparotomy carried out in three patients was negative. All patients were MRSA-negative on admission but had swabs positive for MRSA from ileostomy site postoperatively. All of the three patients who had ileostomy effluent cultured for MRSA had positive results.

DISCUSSION: Fever, abdominal pain, distension and high stoma output in the early postoperative period following bowel surgery should alert the clinician to the possibility of MRSA enteritis. Patients require aggressive resuscitation and culture of ileostomy effluent for MRSA. Exploratory laparotomy has no obvious benefits. As MRSA enteritis has the potential to be a lethally effective disseminator of MRSA, such clinical features should prompt early instigation of appropriate infection control practices.

References: 19 references open in new window

Articles that cite this article?

Keywords: ENTERITIS/MICROBIOLOGY; METHICILLIN RESISTANCE; STAPHYLOCOCCAL INFECTION; ILEOSTOMIES

Document Type: Case report

DOI: http://dx.doi.org/10.1308/003588407X179143

Affiliations: 1: Department of Surgery, Royal Free Hospital, London, UK

Publication date: 2007-04-01

More about this publication?

• The Annals of The Royal College of Surgeons of England is the official journal of the College and is published eight times a year in January, March, April, May, July, September, October and November. The main aim of the journal is to publish high quality, peer-reviewed papers that relate to all branches of surgery.
  
  The Annals also includes letters and comments, a regular technical section, NICE news, controversial topics, CORESS feedback, book reviews and the best trainee presentations from England and Wales. The editorial board is composed of members of the College Council and experts from across the surgical specialties.
  
  Archive issues of the Annals of The Royal College of Surgeons of England are available via the PubMed Central database
  
  To view articles that have been published online ahead of print please click here
• Information for Authors
• Subscribe to this Title
• Information for Advertisers
• The journals of importance to UK clinicians - Survey
• ingentaconnect is not responsible for the content or availability of external websites

Related content

• In this: publication
• By this: publisher
• In this Subject: Medicine ,  Surgery ,  Education
• By this author: Haq, A.I. ;  Cook, L.J.

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers