A preoperative decolonization protocol for staphylococcus aureus prevents orthopaedic infections

Clinical Orthopaedics and Related Research
Nalini RaoRichard L McGough

Abstract

Staphylococcus aureus (S. aureus) is an independent risk factor for orthopaedic surgical site infection (SSI). To determine whether a preoperative decolonization protocol reduces S. aureus SSIs, we conducted a prospective observational study of patients undergoing elective total joint arthroplasty (TJA) at our institution, with two control groups. The concurrent control group comprised patients of surgeons who did not participate in the intervention study. The preintervention control group comprised patients of participating surgeons who had undergone elective TJA during the year before the study. Patients in the intervention group were screened preoperatively for S. aureus by nasal swab cultures. S. aureus carriers were decolonized with mupirocin ointment to the nares twice daily and chlorhexidine bath once daily for 5 days before surgery. All 164 of 636 participants (26%) who tested positive completed the decolonization protocol without adverse events and had no postoperative S. aureus SSIs at 1-year followup. In contrast, 1330 concurrent control patients had 12 S. aureus infections. If these infections had occurred in the 26% of patients expected to be nasal carriers of S. aureus at a given time, the infection rate would hav...Continue Reading

References

Feb 1, 1990·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·J M BoyceL Dziobek
Aug 1, 1996·Antimicrobial Agents and Chemotherapy·L IrizarryJ Griffith
Dec 1, 1996·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Jan A J W KluytmansHenri A Verbrugh
Jul 1, 1997·Clinical Microbiology Reviews·Jan A J W KluytmansHenri A Verbrugh
Oct 20, 1998·The Journal of Hospital Infection·Loreen A Herwaldt
Apr 29, 1999·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·A J MangramW R Jarvis
May 24, 2000·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·M D KalmeijerG A J de Baere
May 11, 2002·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·James D WhitehouseDaniel J Sexton
Jun 14, 2002·The New England Journal of Medicine·Trish M PerlMupirocin And The Risk Of Staphylococcus Aureus Study Team
Jul 30, 2002·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·M D KalmeijerJan A J W Kluytmans
Jan 21, 2003·The Journal of Bone and Joint Surgery. American Volume·Nizar N MahomedJohn A Baron
Mar 5, 2003·The Journal of Antimicrobial Chemotherapy·A UptonH Heffernan
Sep 5, 2003·The Journal of Bone and Joint Surgery. American Volume·Sheleika L HerveyRicardo Pietrobon
Dec 23, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Evelina TacconelliErika M C D'Agata
Feb 9, 2006·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Ana Maria SandriAlexandre Prehn Zavascki
Aug 26, 2006·The Journal of Hospital Infection·A KonvalinkaI W Fong
Oct 13, 2007·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·C WendtH von Baum

Citations

Mar 7, 2013·Surgical Infections·Dale W BratzlerSociety for Healthcare Epidemiology of America (SHEA)
May 23, 2014·Antimicrobial Resistance and Infection Control·Kevin KavanaghSaid Abusalem
Jun 28, 2014·Orthopedics·Jed MaslowJoseph Bosco
Jan 10, 2012·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Xan F CourvilleSamuel R G Finlayson
Jun 11, 2014·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Susan KlineTrish M Perl
Dec 7, 2010·Aesthetic Surgery Journal·Michael A LaneBernard C Camins
Apr 2, 2014·Burns : Journal of the International Society for Burn Injuries·M E H JaspersB M W Diederen
Feb 25, 2017·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Andrew J MeyrNaohiro Shibuya
Aug 8, 2015·Geriatric Orthopaedic Surgery & Rehabilitation·Simon C Mears, Stephen L Kates
May 15, 2015·Antimicrobial Resistance and Infection Control·Jean Marie ArduinoDeverick J Anderson
Nov 16, 2017·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Cortney E HeimTammy Kielian
Sep 8, 2018·Telemedicine Journal and E-health : the Official Journal of the American Telemedicine Association·Alexander T YahandaJohn P Kirby
Jun 15, 2011·Clinical Orthopaedics and Related Research·Kenneth A KearnsDonald Jungkind
Jan 17, 2019·The Bone & Joint Journal·V K Alamanda, B D Springer
Jan 29, 2010·European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology·P BerthelotF Lucht
May 21, 2010·Current Opinion in Infectious Diseases·Courtney Hebert, Ari Robicsek
Jan 14, 2011·Plastic and Reconstructive Surgery·George Cierny
Apr 24, 2019·Expert Review of Anti-infective Therapy·Adèle SakrOlivier Blin
Jun 5, 2010·Expert Review of Anti-infective Therapy·Ilker UçkayDidier Pittet
Mar 24, 2012·Clinical Orthopaedics and Related Research·Antonia F ChenJoon Y Lee
Feb 1, 2014·HSS Journal : the Musculoskeletal Journal of Hospital for Special Surgery·Benjamin F RicciardiAnnette W-Dahl
May 27, 2014·American Society of Clinical Oncology Educational Book·Robert M Henshaw
Oct 3, 2009·The Journal of Bone and Joint Surgery. American Volume·John MeehanHien Nguyen
Dec 9, 2010·The Journal of Bone and Joint Surgery. American Volume·Wadih Y MatarJavad Parvizi
May 19, 2009·Current Opinion in Infectious Diseases·Anna L Casey, Tom S J Elliott
Jun 4, 2016·Dimensions of Critical Care Nursing : DCCN·Susan GeorgeDouglas Horstmanshof
May 24, 2015·The Journal of the American Academy of Orthopaedic Surgeons·Brian K DainesSean Amann
Aug 10, 2012·Journal of Patient Safety·Kevin KavanaghDaniel M Saman
Aug 14, 2019·Open Forum Infectious Diseases·William J O'BrienKamal M F Itani
Mar 7, 2013·Clinical Orthopaedics and Related Research·Antonia F ChenNalini Rao
Mar 6, 2013·Clinical Orthopaedics and Related Research·Demetri M EconomedesCarl A Deirmengian
Mar 19, 2013·Clinical Orthopaedics and Related Research·Nicholas J FarberBrian A Klatt

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