Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty
Objective: The aim of this study was to evaluate whether the establishment of a preoperative screening and decolonization protocol for Staphylococcus aureus carriers undergoing total knee arthroplasty (TKA) could decrease the incidence of periprosthetic joint infection (PJI) caused by this microorga...
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AVES Yayincilik
2019-11-01
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Series: | Acta Orthopaedica et Traumatologica Turcica |
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doaj-5ad9e5d8405045018f636609bbce4b572020-11-25T03:56:02ZengAVES YayincilikActa Orthopaedica et Traumatologica Turcica1017-995X2019-11-01536426431Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplastyXavier Pelfort0Alba Romero1Montserrat Brugués2Amparo García3Sergi Gil4Anna Marrón5Department of Orthopaedics and Trauma, Consorci Sanitari de l'Anoia - Hospital d'Igualada, Barcelona, Spain; Hospital Universitari Quirón-Dexeus, ICATME - EQUILAE, Barcelona, Spain; Corresponding author. Department of Orthopaedics and Trauma, Consorci Sanitari de l’Anoia - Hospital d’Igualada, Barcelona, Spain. Tel.: +34 606674861; fax: +34 938075537.Department of Orthopaedics and Trauma, Consorci Sanitari de l'Anoia - Hospital d'Igualada, Barcelona, SpainDepartment Nosocomial Infection, Consorci Sanitari de l'Anoia - Hospital d’Igualada, Barcelona, SpainDepartment of Microbiology, Consorci Sanitari de l'Anoia - Hospital d’Igualada, Barcelona, SpainDepartment of Orthopaedics and Trauma, Consorci Sanitari de l'Anoia - Hospital d'Igualada, Barcelona, SpainDepartment of Internal Medicine, Consorci Sanitari de l'Anoia - Hospital d’Igualada, Barcelona, SpainObjective: The aim of this study was to evaluate whether the establishment of a preoperative screening and decolonization protocol for Staphylococcus aureus carriers undergoing total knee arthroplasty (TKA) could decrease the incidence of periprosthetic joint infection (PJI) caused by this microorganism. Methods: We conducted a retrospective study comparing a control group comprising 400 patients (134 men, and 266 women; mean age: 72.2 ± 6.8 years) who went through surgery between January 2009 and December 2013, with a second intervention group of 403 patients (125 men, and 278 women; mean age: 72.4 ± 6.9 years) in which the protocol of screening and decolonization of S. aureus nasal carriers was applied between January 2014 and December 2016. During this latter period patients were preoperatively screened and, if positive, treated with mupirocin nasal ointment and chlorhexidine soap, for 5 days prior to surgery. Results: In the control group, 17 of 400 patients (4.2%) had a SSI, 8 (2%) of them caused by S. aureus and 9 (2.2%) by other microorganisms. In the intervention group 20.6% of patients had a positive S. aureus nasal swab and were treated according to the protocol. 5 of 403 patients (1.2%) in this group had a SSI, 1 (0.2%) due to S. aureus and 4 (1%) to other microorganisms. When comparing surgical-site infection (SSI) rates between the two groups, we found a statistically significant reduction in both global SSI (p = 0.009) and specifically S. aureus SSI (p = 0.02), in the intervention group. No decolonized S. aureus nasal carrier presented a SSI. Discussion: In patients undergoing TKA a preoperative screening and decolonization protocol for S. aureus nasal carriers, using mupirocin nasal ointment and chlorhexidine soap, is an effective measure to reduce the rate of SSI caused by this microorganism. Level of Evidence: Level III; Therapeutic Study. Keywords: S. aureus, TKA infection, Screening protocol, Decolonization protocol, TKR infectionhttp://www.sciencedirect.com/science/article/pii/S1017995X1930389X |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xavier Pelfort Alba Romero Montserrat Brugués Amparo García Sergi Gil Anna Marrón |
spellingShingle |
Xavier Pelfort Alba Romero Montserrat Brugués Amparo García Sergi Gil Anna Marrón Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty Acta Orthopaedica et Traumatologica Turcica |
author_facet |
Xavier Pelfort Alba Romero Montserrat Brugués Amparo García Sergi Gil Anna Marrón |
author_sort |
Xavier Pelfort |
title |
Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty |
title_short |
Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty |
title_full |
Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty |
title_fullStr |
Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty |
title_full_unstemmed |
Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty |
title_sort |
reduction of periprosthetic staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty |
publisher |
AVES Yayincilik |
series |
Acta Orthopaedica et Traumatologica Turcica |
issn |
1017-995X |
publishDate |
2019-11-01 |
description |
Objective: The aim of this study was to evaluate whether the establishment of a preoperative screening and decolonization protocol for Staphylococcus aureus carriers undergoing total knee arthroplasty (TKA) could decrease the incidence of periprosthetic joint infection (PJI) caused by this microorganism. Methods: We conducted a retrospective study comparing a control group comprising 400 patients (134 men, and 266 women; mean age: 72.2 ± 6.8 years) who went through surgery between January 2009 and December 2013, with a second intervention group of 403 patients (125 men, and 278 women; mean age: 72.4 ± 6.9 years) in which the protocol of screening and decolonization of S. aureus nasal carriers was applied between January 2014 and December 2016. During this latter period patients were preoperatively screened and, if positive, treated with mupirocin nasal ointment and chlorhexidine soap, for 5 days prior to surgery. Results: In the control group, 17 of 400 patients (4.2%) had a SSI, 8 (2%) of them caused by S. aureus and 9 (2.2%) by other microorganisms. In the intervention group 20.6% of patients had a positive S. aureus nasal swab and were treated according to the protocol. 5 of 403 patients (1.2%) in this group had a SSI, 1 (0.2%) due to S. aureus and 4 (1%) to other microorganisms. When comparing surgical-site infection (SSI) rates between the two groups, we found a statistically significant reduction in both global SSI (p = 0.009) and specifically S. aureus SSI (p = 0.02), in the intervention group. No decolonized S. aureus nasal carrier presented a SSI. Discussion: In patients undergoing TKA a preoperative screening and decolonization protocol for S. aureus nasal carriers, using mupirocin nasal ointment and chlorhexidine soap, is an effective measure to reduce the rate of SSI caused by this microorganism. Level of Evidence: Level III; Therapeutic Study. Keywords: S. aureus, TKA infection, Screening protocol, Decolonization protocol, TKR infection |
url |
http://www.sciencedirect.com/science/article/pii/S1017995X1930389X |
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