Eradication of methicillin-resistant Staphylococcus aureus from pressure sores using warming therapy

Background: Nosocomial infection is a major cause of surgical morbidity and mortality. Methicillin-resistant Staphylococcus aureus (MRSA) has become a prominent organism in colonization and infection in surgical patients. Pressure sores are a major reservoir of MRSA. Materials and Methods: In this study, 33 patients with full-thickness pressure sores were randomized to receive standard care or radiant heat therapy using a Warm Up device (Augustine Medical, Eden Prairie, MN). Weekly microbial sampling was used for assessment of bacterial presence. None of the patients received antibiotics prior to or during the eight weeks of study. Results: More than 50 species of bacteria were present in the pressure sores with a median of four organisms per sample. Methicillin-resistant S. aureus was found in 14 of the patients' pressure sores. In the warming group (n = 8), MRSA was eradicated in six patients within 2 weeks of warming, whereas in the control group none had eradication (Fisher's exact test, p = 0.01). Eradication was defined as three consecutive weekly swabs without bacterial growth. Conclusion: The warming of pressure sores is being assessed as an adjunct to healing, but there is some promise that colonization by MRSA may be eradicated, thereby reducing a potential reservoir of organisms. The risk to surgical patients when patients are harboring MRSA may be minimized by warming therapy.