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. 2008 Jun;466(6):1349-55.
doi: 10.1007/s11999-008-0210-y. Epub 2008 Mar 18.

Staphylococcus aureus nasal decolonization in joint replacement surgery reduces infection

Donna M Hacek  1 , William J Robb, Suzanne M Paule, James C Kudrna, Van Paul Stamos, Lance R Peterson
Affiliations

Staphylococcus aureus nasal decolonization in joint replacement surgery reduces infection

Donna M Hacek et al. Clin Orthop Relat Res. 2008 Jun.

Abstract

Surgical site infections (SSIs) with Staphylococcus aureus are a recognized adverse event of hip and knee replacements. We evaluated the impact of a program to detect S. aureus nasal carriers before surgery with preoperative decolonization (using mupirocin twice daily for 5 days prior to surgery) of carriers. Nasal swab samples were obtained from patients prior to surgery from 8/1/2003 through 2/28/2005. Samples were tested using real-time PCR technology to detect S. aureus. The group that developed S. aureus SSI was compared to a combined concurrent and historical control for one year following the operation. S. aureus caused 71% of SSIs in the combined control groups. Of the 1495 surgical candidates evaluated, 912 (61.0%) were screened for S. aureus; 223 of those screened (24.5%) were positive and then decolonized with mupirocin. Among the 223 positive and decolonized patients, three (1.3%) developed a SSI. Among the 689 screen-negative patients, four (0.6%) developed SSIs for an overall rate of 0.77%. Among the 583 control patients who were not screened or decolonized, 10 (1.7%) developed S. aureus SSIs. SSIs from other organisms were 0.44% and 0.69%, respectively.

Level of evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Figures

Fig. 1
Fig. 1
The surgical site infections (SSIs) of patients with and without presurgical nasal screening and nasal decolonization for S. aureus are outlined.
See this image and copyright information in PMC

References

    1. Anderson DJ, Sexton DJ, Kanafani ZA, Auten G, Kaye KS. Severe surgical site infection in community hospitals: epidemiology, key procedures, and the changing prevalence of methicillin-resistant Staphylococcus aureus. Infect Control Hosp Epidemiol. 2007;28:1047–1053. doi: 10.1086/520731. - DOI - PubMed
    1. Bozic KJ, Ries MD. The impact of infection after total hip arthroplasty on hospital and surgeon resource utilization. J Bone Joint Surg Am. 2005;87:1746–1751. doi: 10.2106/JBJS.D.02937. - DOI - PubMed
    1. Cimochowski GE, Harostock MD, Brown B, Bernardi M, Alonzo N, Coyle K. Intranasal mupirocin reduces sternal wound infection after open heart surgery in diabetics and nondiabetics. Ann Thorac Surg. 2001;71:1572–1579. doi: 10.1016/S0003-4975(01)02519-X. - DOI - PubMed
    1. Horan TC, Gaynes RP. Surveillance of nosocomial infections. In: Mayhall GC, editor. Hospital Epidemiology and Infection Control. 3. Philadelphia, PA: Lippincott Williams and Wilkins; 2004. pp. 1659–1702.
    1. Kallen AJ, Wilson CT, Larson RJ. Perioperative intranasal mupirocin for the prevention of surgical-site infections: systematic review of the literature and meta-analysis. Infect Control Hosp Epidemiol. 2005;26:916–922. doi: 10.1086/505453. - DOI - PubMed

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