Screening for S. aureus carriage

For patients undergoing arthroplasty procedures or cardiothoracic procedures involving median sternotomy, perform preoperative screening and decolonise colonised patients.

There are fewer data to support preoperative screening, and decolonisation of colonised patients, for other surgical procedures. However, strongly consider screening and decolonising patients undergoing surgical procedures in which prosthetic material is implanted, because S. aureus is the most common cause of postoperative infection of prosthetic implants. Also consider screening and decolonising patients undergoing other surgical procedures.

Detection of S. aureus carriage is improved when swabs from multiple sites (eg nose and groin) are cultured, compared to swabs from the nose alone.

The request for microscopy, culture and susceptibility testing should specify that the sample be screened for both MSSA and MRSA.