Indications for preoperative screening for Staphylococcus aureus (MSSA or MRSA) nasal carriage and preoperative staphylococcal load reduction (HNE LHD):

• Open cardiac and valve procedures
• Shoulder, hip or knee joint total arthroplasties: primary or revision procedures
• Aortic work (stent and open) and all lower limb open surgery for vascular reconstructions (bypass, endarterectomy). Iliac stents (as they are a covered stent)
• Haemodialysis catheter insertions

Actions 

• Screen for MSSA or MRSA carriage with a single nose swab culture (repeat if surgery delayed > 1 month)
• Carriers of MSSA or MRSA have staphylococcal load reduction performed in the week prior to surgery

Information sheets (HNE Health)

• For clinicians: Pre-Procedure Staph load reduction HNE 14Apr23
• For consumers: Staph load reduction NS2APPROVED HNE 11Aug23

Surgical antibiotic prophylaxis recommendations

• See PPG : Surgical Antimicrobial Prophylaxis – District – Hospital HealthPathways Hunter New England (updated 26Jul24)

Reference

• PD2023_025_PCP_33_Preoperative_procedures_prevention_of_infections (updated 19Jan24)