Preoperative screening for nasal carriage of methicillin-resistant Staphylococcus aureus in patients undergoing general thoracic surgery / Journal of Rural Medicine

Objectives: Nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for surgical site infections (SSIs). However, few studies have evaluated the rate of nasal carriage of MRSA and its effect on SSIs in patients undergoing general thoracic surgery. We investigated the importance of preoperative screening for nasal carriage of MRSA in patients undergoing general thoracic surgery.Patients and Methods: We retrospectively analyzed 238 patients with thoracic diseases who underwent thoracic surgery. We reviewed the rates of nasal carriage of MRSA and SSIs.Results: Results of MRSA screening were positive in 11 of 238 patients (4.6%), and 9 of these 11 patients received nasal mupirocin. SSIs occurred in 4 patients (1.8%). All 4 patients developed pneumonia; however, MRSA pneumonia occurred in only 1 of these 4 patients. No patient developed wound infection, empyema, and/or mediastinitis. SSIs did not occur in any of the 11 patients with positive results on MRSA screening.Conclusions: The rates of nasal carriage of MRSA and SSIs were low in this case series. Surveillance is important to determine the prevalence of MRSA carriage and infection in hospitals, particularly in the intensive care unit. However, routine preoperative screening for nasal carriage of MRSA is not recommended in patients undergoing general thoracic surgery.

Faculty development for clinical education in the age of international accreditation: A case study of "Teaching in Clinical Settings: A Practicum Course" at McGill University / 医学教育

<p>　To effectively educate medical teachers for clerkship and residency training, the international faculty development program was developed. Ten faculties of the School of Medicine participated in the program and learned about clinical education through lectures and direct observations, transforming their educational perspectives. Factors to optimize such an international faculty development program were discussed: 1) Authentic educational institution and environment, 2) matching the participants' specialty and subject at the observation site, 3) optimal combination of lectures, direct observations, and debriefing sessions, 4) mutual understanding of cultural differences, and 5) sense of community cultivated by experiencing the program for a week. Those factors suggest ways for further improvement to reform the program, promote better management, and conduct educational research on faculty development.</p>