Abstract 129P
Background
Surgical site infection (SSIs) is a significant complication following bone cancer surgery, often resulting in reoperation, prolonged antibiotic use, and delays in chemotherapy. It is critical for patients with bone cancer due to the invasiveness of the surgery, immune suppression, and chemotherapy regimens they undergo. In an effort to reduce SSIs rate, our sarcoma teams implemented a new intervention – pre-surgery screening for methicillin-resistant Staphylococcus aureus (MRSA).
Methods
A cross-sectional study was conducted, encompassing all planned bone cancer surgery patients at Vinmec Times City from June 29, 2022, to September 28, 2023, and were subjected to interventions. The interventions included active surveillance for MRSA screening (nasal swab) and eradication and adjusting prophylactic antibiotic regimens based on MRSA risk assessment. Our study aims to describe clinical characteristics and identify the 90-day postoperative SSI rate.
Results
Seventy-two patients underwent interventions, the average age was 21.8 years with an equal male-to-female ratio. The majority of patients exhibited pathological results indicative of conventional osteosarcoma, constituting 75% of cases, with half involving the femur. This study revealed a 15.3% MRSA-positive screening rate. Predominantly, surgeries were conducted employing the principle of wide resection (95.8%) and joint replacement was performed in 80.1% of cases. A notable proportion of patients experienced operation times exceeding 4 hours (76.4%). The primary outcome was 90-day postoprerative SSI rate representing 2.8% of cases. Only two cases were reported, both classified as multiorganism organ/space SSIs with MRSA and Pseudomonas aeruginosa, with an additional instance of Escherichia coli in one patient.
Conclusions
The implementation of MRSA screening results demonstrated a notable achievement, with a relatively low 90-day postoperative SSI rate of 2.8%. However, each SSI case poses a financial burden and prolonged treatment duration. Further investigations to identify potential contributing factors to improve SSI prevention strategies, ultimately optimizing the overall outcomes for bone cancer surgical patients.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.