Positive nasal culture of methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for surgical site infection in orthopedics

Background Although nasal carriage of MRSA has been identified as one of the risk factors for surgical site infection (SSI) with MRSA, there have been no reports of this in the orthopedics field. Methods This prospective observational cohort study included 2,423 consecutive patients who were admitte...

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Bibliographic Details
Published in:Acta orthopaedica 2009, Vol.80 (4), p.486-490
Main Authors: Yano, Koichi, Minoda, Yukihide, Sakawa, Akira, Kuwano, Yoshihiro, Kondo, Kyoko, Fukushima, Wakaba, Tada, Koichi
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carrier State - microbiology
Carrier State - prevention & control
Cohort Studies
Female
Humans
Male
Methicillin-Resistant Staphylococcus aureus - isolation & purification
Middle Aged
Nasal Cavity - microbiology
Prospective Studies
Prosthesis-Related Infections - microbiology
Prosthesis-Related Infections - prevention & control
Risk Factors
Staphylococcal Infections - drug therapy
Staphylococcal Infections - microbiology
Surgical Wound Infection - microbiology
Surgical Wound Infection - prevention & control
Young Adult
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Summary:Background Although nasal carriage of MRSA has been identified as one of the risk factors for surgical site infection (SSI) with MRSA, there have been no reports of this in the orthopedics field. Methods This prospective observational cohort study included 2,423 consecutive patients who were admitted to our department over 26 months and who underwent orthopedic surgery. We examined the relationship between pre-existing nasal MRSA and subsequent occurrence of SSI with MRSA. Results 63 patients (2.6%) had a positive nasal MRSA culture. 15 patients (0.6%) developed SSI with MRSA. The occurrence of SSI with MRSA in nasal MRSA carriers was significantly higher than that in non-carriers (4 out of 63 (6.3%) vs. 11 out of 2,360 (0.5%); p < 0.001) (adjusted OR: 11; 95% CI: 3–37; p = 0.001). Interpretation We recommend appropriate treatment of patients who are nasal carriers of MRSA before orthopedic surgery.
ISSN:1745-3674
1745-3682
DOI:10.3109/17453670903110675