Preoperative Screening/decolonization for Staphylococcus Aureus to Prevent Orthopedic Surgical Site Infection: Prospective Cohort Study with 2-year Follow-up

Overview

Journal J Arthroplasty

Specialty Orthopedics

Date 2011 Apr 22

PMID 21507604

Citations 37

Authors

Nalini Rao

Barbara A Cannella

Lawrence S Crossett

Adolph J Yates Jr

Richard L McGough 3rd

Cindy W Hamilton

Affiliations

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Abstract

We quantified surgical site infections (SSIs) after preoperative screening/selective decolonization before elective total joint arthroplasty (TJA) with 2-year follow-up and 2 controls. Concurrent controls (n = 2284) were patients of surgeons not participating in screening/decolonization. Preintervention controls (n = 741) were patients of participating surgeons who underwent TJA the previous year. Staphylococcus aureus nasal carriers (321/1285 [25%]) used intranasal mupirocin and chlorhexidine baths as outpatients. Staphylococcal SSIs occurred in no intervention patients (0/321) and 19 concurrent controls. If all SSIs occurred in carriers and 25% of controls were carriers, staphylococcal SSI rate would have been 3.3% in controls (19/571; P = .001). Overall SSI rate decreased from 2.7% (20/741) in preintervention controls to 1.2% (17/1440) in intervention patients (P = .009). Preoperative screening/selective decolonization was associated with fewer SSIs after elective TJA.

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