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Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus Screening and Decolonization to Reduce Surgical Site Infection in Elective Total Joint Arthroplasty.
- Source :
-
The Journal of arthroplasty [J Arthroplasty] 2016 Sep; Vol. 31 (9 Suppl), pp. 144-7. Date of Electronic Publication: 2016 May 18. - Publication Year :
- 2016
-
Abstract
- Background: Deep infection after elective total joint arthroplasty remains a devastating complication. Preoperative nasal swab screening for Staphylococcus aureus colonization and subsequent treatment of colonized patients is one proposed method to identify at-risk patients and decrease surgical site infections (SSIs). The purpose of this study was to determine whether a preoperative staphylococcus screening and treatment program would decrease the incidence of SSI in elective joint arthroplasty patients.<br />Methods: Since January 2009, a total of 9690 patients having an elective joint arthroplasty were screened before surgery for Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) with nares swabs. All patients with positive nare colonization for MSSA and MRSA were treated with mupirocin and chlorhexidine gluconate showers for 5 days before surgery. MRSA patients received vancomycin preoperatively and were placed in contact isolation. All elective arthroplasty patients used chlorhexidine gluconate antiseptic cloths the evening prior and the day of surgery. Perioperative infection rates were compared from 1 year before implementation to 5 years after implementation of this screening protocol.<br />Results: SSI rates have decreased from 1.11% (prescreening) to 0.34% (nasal screening; P < .05) after initiation of the process. Staphylococcus was identified in 66.7% of the SSI infections before nasal screening and in 33.3% of the SSI after routine screening (P > .05).<br />Conclusion: The addition of MRSA and/or MSSA nares screening along with a perioperative decolonization protocol has resulted in a decreased SSI rate by 69%.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Administration, Intranasal
Aged
Arthroplasty
Chlorhexidine analogs & derivatives
Chlorhexidine therapeutic use
Elective Surgical Procedures
Female
Humans
Incidence
Male
Methicillin
Methicillin Resistance
Middle Aged
Nasal Cavity microbiology
Preoperative Care
Staphylococcal Infections diagnosis
Staphylococcal Infections drug therapy
Staphylococcus aureus
Surgical Wound Infection epidemiology
Surgical Wound Infection microbiology
Vancomycin therapeutic use
Anti-Infective Agents, Local therapeutic use
Arthroplasty, Replacement
Methicillin-Resistant Staphylococcus aureus isolation & purification
Mupirocin therapeutic use
Surgical Wound Infection prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8406
- Volume :
- 31
- Issue :
- 9 Suppl
- Database :
- MEDLINE
- Journal :
- The Journal of arthroplasty
- Publication Type :
- Academic Journal
- Accession number :
- 27387479
- Full Text :
- https://doi.org/10.1016/j.arth.2016.05.019