CHICAGO (Reuters) – A dangerous drug-resistant bacterial infection has been showing up in a small number of patients who undergo face-lifts, doctors reported on Monday.
When infections do occur at surgical sites following such procedures "the facial plastic surgeon should have a high suspicion" for MRSA (methicillin-resistant Staphylococcus aureus), as the source, they said.
Dr. Richard Zoumalan of Lennox Hill-Manhattan Eye, Ear, and Throat Hospital in New York and the New York University School of Medicine and Dr. David Rosenberg also of the Lennox Hill center said a review of 780 U.S. face-lift patients from 2001 to 2007 found five — 0.6 percent — with infections at incision sites. Four were confirmed as MRSA, all in 2006.
Of the four, two patients appeared to have been exposed to the bacteria before surgery — one who had spent time with her spouse in a cardiac intensive care unit four months earlier, and another who had frequent contact with her brother-in-law, a cardiologist, the report said.
As many as 1.5 percent of Americans carry the highly contagious infection and may spread it to others without developing a serious infection themselves. It was blamed for an estimated 19,000 deaths in 2005 in the United States.
It has become the most common cause of all infections at surgical incision sites, and about 85 percent of cases happen in hospitals where the infection can kill the weak.
"It’s not surprising that it has been found in cosmetic surgery," Rosenberg said in an interview; adding that the study was the first to confirm it.
He said follow-up research he and Zoumalan have done has found no additional cases of MRSA in face-lift surgeries where the skin was pre-treated to kill the bacteria.
Since people enter hospitals with the bacteria, he said, "the emphasis has to be on pre-treatment."
The report published in the current issue of the Archives of Facial Plastic Surgery said doctors who perform face-lifts may want to start screening patients to track down those who may be at risk.
"During preoperative evaluation, a full medical history should include information on possible prior contacts with persons at high risk for carrying MRSA," the study said.
"Other risk factors include age, diabetes, smoking, obesity, and prolonged postoperative stay. Groups with higher incidence … include athletes, military personnel, prison inmates, men who have sex with men, intravenous drug users, native Americans and Pacific Islanders," it added.
The post-surgery infection rate found in the study was about the same as that found in research done 10 years ago, but the earlier study was done when MRSA was still rare, the authors said.