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. 2017 Sep;6(9):566-571.
doi: 10.1302/2046-3758.69.BJR-2017-0066.R2.

The role of routine screening in blood-borne pathogens in Chinese patients undergoing joint arthroplasty

T Cheng  1 , X-L Zhang  2 , J-J Hu  3 , B Li  4 , Q Wang  2
Affiliations

The role of routine screening in blood-borne pathogens in Chinese patients undergoing joint arthroplasty

T Cheng et al. Bone Joint Res. 2017 Sep.

Abstract

Objectives: Surgeons face a substantial risk of infection because of the occupational exposure to blood-borne pathogens (BBPs) from patients undergoing high-risk orthopaedic procedures. This study aimed to determine the seroprevalence of four BBPs among patients undergoing joint arthroplasty in Shanghai, China. In addition, we evaluated the significance of pre-operative screening by calculating a cost-to-benefit ratio.

Methods: A retrospective observational study of pre-operative screening for BBPs, including hepatitis B and C viruses (HBV and HCV), human immunodeficiency virus (HIV) and Treponema pallidum (TP), was conducted for sequential patients in the orthopaedic department of a large urban teaching hospital between 01 January 2009 and 30 May 2016. Medical records were analysed to verify the seroprevalence of these BBPs among the patients stratified by age, gender, local origin, type of surgery, history of previous transfusion and marital status.

Results: Of the subjects who underwent arthroplasty surgery in our institution, pre-operative screening tests were available for 96.1% (11 609 patients). The seroprevalence of HBV, HCV, HIV and TP was 5.47%, 0.45%, 0.08% and 3.6%, respectively. A total of 761 seropositive cases (68.4%) were previously undiagnosed. Pre-operative screening for HIV resulted in a low cost to benefit ratio, followed by HCV and HBV.

Conclusion: Routine HCV and HIV screening prior to joint arthroplasty is not a cost-effective strategy. Considering the high rate of undiagnosed patients and the shortage of protective options, targeted pre-operative screening for HBV and syphilis should be considered for the protection of healthcare workers in China who have not been vaccinated.Cite this article: Bone Joint Res 2017;6:566-571.

Keywords: Blood-borne pathogens; Joint arthroplasty; Pre-operative screening.

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Conflict of interest statement

Conflicts of Interest Statement: None declared

Figures

Fig. 1
Fig. 1
Graph showing the distribution of Hepatitis B virus seroprevalence among patients by age (years) and gender.
See this image and copyright information in PMC

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References

    1. Wong KC, Leung KS. Transmission and prevention of occupational infections in orthopaedic surgeons. J Bone Joint Surg [Am] 2004;86-A:1065-1076. - PubMed
    1. Wendlandt R, Thomas M, Kienast B, Schulz AP. In-vitro evaluation of surgical helmet systems for protecting surgeons from droplets generated during orthopaedic procedures. J Hosp Infect 2016;94:75-79. - PubMed
    1. Singh BI, Nurein H, Sinha S, Singh S, Housden P. Risk of conjunctival contamination in total joint arthroplasty. J Hosp Infect 2006;63:275-280. - PubMed
    1. Maniar HH, Tawari AA, Suk M, Bowen TR, Horwitz DS. Percutaneous and mucocutaneous exposure among orthopaedic surgeons: immediate management and compliance with CDC protocol. J Orthop Trauma 2015;29:e391-e394. - PubMed
    1. Alani A, Modi C, Almedghio S, Mackie I. The risks of splash injury when using power tools during orthopaedic surgery: a prospective study. Acta Orthop Belg 2008;74:678-682. - PubMed