Guidelines for Complications of Cancer Treatment Vol VIII Part B

such as concomitant use of prophylactic antibiotics. Otherstudies did not find a statistically significant difference betweenthe two operating room environments 32 . Currently, the role oflaminar airflow in the prophylaxis is controversial ifprophylactic antibiotics are used.Control measures for methicillin-resistantStaphylococcus aureusMRSA has become an important cause of surgical woundinfections, with an increased incidence within both hospitalsand the community. Monthly bacterial colonization rates varybetween 6.6% and 23%, with an MRSA infection rate of3% 33,34 . This are likely to be higher in India. Simple measures,such as meticulous hand hygiene, patient screening, carefulsurveillance of infections, and prompt implementation ofisolation policies, are essential components of control 35-37 .Preoperative nasal carriage of S. aureus represents a risk factorfor surgical site infections 7 . Up to 5.3% of orthopedic patientsare colonized with methicillin-resistant strains of staphylococcion hospital admission 38 . Current guidelines advocate screeningfor MRSA carriage in patients at high risk (ie, patients whohave spent more than 5 days in acute or long-term carecenters) 39 .Intranasal mupirocin has been evaluated in the prevention ofsurgical site infections. Although intranasal mupirocin reducednasal carriage of S aureus, several studies failed to demonstratea significant reduction in surgical site infection rates 40-42 . Inone study, the rate of endogenous S aureus infections was fivetimes lower in the mupirocin group than in placebo group(0.3% and 1.7%, respectively), although this difference wasnot statistically significant 40 . Other studies have shown apotential benefit in reduction of surgical site infections by usingmupirocin. One study that used a historical control groupshowed a significant reduction in the surgical site infection129