PROTECT (PRe-surgical Opportunistic TEsting for Colonisation of sTaphylococcus

Ms Gemma Mallin1, Mr Ezra Njuguna1, Mr  Andrew  Bridgeman Mrs Belinda Andrews2, Dr Matthew Horton1, Dr Sheen Peeceeyen1, Dr Con Manganas1, Dr Gary Fermanis1, Ms Rachel Stocker1, Mr Rajram Shrestha1, Mr Hala  Klobuchar1, Ms Sarka Hartmannova2, Dr Jeffrey Post2, Dr Hugh  Wolfenden2, Mr Gareth  Hockey2, Ms Genevieve Gardner2

1St George Public Hospital
2Prince of Wales Public Hospital

Introduction: The PROTECT (PRe-surgical Opportunistic TEsting for Colonisation of sTaphylococcus) program was introduced as part of the cardiothoracic surgical site infection care bundle to reduce surgical site infections (SSI) in coronary artery bypass graft (CABG) surgeries. The aim of the PROTECT program was to reduce harm caused by colonisation of Staphylococcus aureus for patients undergoing CABG at St George Public Hospital (SGH) and Prince of Wales Public Hospital (POW).

Methods: The implementation involved creation of procedural guidance, and education of patients, nursing and medical staff. Patients scheduled for CABG are screened for Methicillin Sensitive Staphylococcus aureus (MSSA) and Methicillin Resistant Staphylococcus aureus (MRSA). Patients with positive results commence decolonisation treatment which involves application of twice daily intra nasal ointment and use of a daily antimicrobial body wash for five days prior to their day of surgery. For patients admitted as emergency admissions for CABG, screening is done as soon as possible and a decolonisation treatment commenced if a risk assessment determines the patient has a high risk of Staphylococcus aureus colonisation.

Results: There has been sustained improvement in screening and decolonisation process at SGH and POW with screening above 90% at both hospitals. Consequently, CABG SSI have reduced with one deep CABG SSI in the last 12 months at SGH and reductions in deep CABG SSI at POW.

Conclusion: The PROTECT program is a key patient safety initiative to minimise cardiothoracic surgical site infections. SGH and POW have been able to achieve a sustained increase in screening and decolonisation treatment.


Ezra has a strong clinical background in cardiothoracic nursing and has had the privilege of working in clinical settings in both the USA and Australia. Ezra is currently enjoying the challenge of working as a Clinical Nurse Consultant in Infection Prevention & Control.

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