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General Surgery

Answer 3
  1. Patients who have had surgical procedures involving the implantation of prosthetic materials or devices. The Society for Healthcare Epidemiology of America recently recommended routine surveillance cultures at the time of admission to the hospital for patients at high risk for carrying MRSA. Rates of MRSA colonization may be higher among patients who are on dialysis or have previously spent 15 days in an institutional setting, including long-term acute care centers.3 For these patients as well as patients allergic to penicillin, vancomycin should be considered as the appropriate antimicrobial agent for prophylaxis. Routine vancomycin prophylaxis in surgical procedures involving prosthetic materials or devices is not advised.

    3. Muto CA, Jernigan JA, Ostrowsky BE, et al. SHEA guideline for preventing nosocomial transmission of multidrug-resistant strains of Staphylococcus aureus and enterococcus. Infect Control Hosp Epidemiol 2003;24:362-86.

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