Rapid and economical detection of eight carbapenem-resistance genes in Enterobacteriaceae, Pseudomonas spp, and Acinetobacter spp directly from positive blood cultures using an internally controlled multiplex-PCR assay

This was also true for patients undergoing cardiac surgery in the STOP SSI study (cited by Ariyo et al)2 and similar subsequent unpublished studies. In the STOP SSI study, the significant reduction in complex S. aureus SSIs was only seen among orthopedic surgery patients but not cardiac surgery patients. The orthopedic surgery patients tended to be scheduled for elective surgery and had outpatient preoperative clinic visits in the 30 days prior to surgery. During this visit, the orthopedic patients were provided chlorhexidine body wash, were screened for S. aureus colonization and, if positive, were provided with a 5-day supply of mupirocin nasal ointment. In contrast, the cardiac surgery patients did not have a standardized outpatient preoperative clinic appointment and were often only seen in the inpatient setting. Similarly, only 1.6% of patients undergoing urgent/emergent operations were fully adherent to the STOP SSI bundle, 40% of patients undergoing scheduled operations were fully adherent. This factor was reflected in the outcomes, in which there was only a statistically significant reduction in complex S. aureus SSIs among the scheduled operations and not the urgent/emergent operations. In a similar study performed in Veterans Affairs (VA) hospitals, a cardiac case manager from a small VA hospital stated: