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General Orthopaedics

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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_15 | Pages 328 - 328
1 Mar 2013
Shimizu T Kato M Ono Y Yasura K Aoto T Hirakawa A Matsuo H Kyo M
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Purpose

Surgical site infection (SSI) is an infrequent but serious complication of total joint arthroplasty (TJA). Orthopaedic SSI causes substantial morbidity, prolonging the hospital stay by a median of 2 weeks, doubling the rates of rehospitalization, and more than tripling overall healthcare costs. Colonization with methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive S. aureus (MSSA) is known to be associated with an increased risk of subsequent SSI. Carriers are two to nine times more likely to acquire S. aureus SSIs than non-carriers. Screening of the nose and throat for MRSA colonization and preoperative patient decolonization have been shown to decrease the incidence of subsequent MRSA infection. The aim of this study was to investigate the association between the results of MRSA colonization screening and the incidence of SSI in our hospital.

Materials and Methods

Between June 2007 and June 2010, 238 patients were admitted for TJA, among whom 235 underwent preoperative assessment that included screening of the nose and throat for MRSA colonization. Fifty-nine of these patients underwent total hip arthroplasty (THA), 69 underwent total knee arthroplasty (TKA), 6 underwent unilateral knee arthroplasty (UKA), and 101 underwent bipolar hip prosthesis arthroplasty (BPH). The mean age of the patients was 72.7 (49–95) years and the male to female ratio was 1:3.8. We analyzed these patients retrospectively, and determined the site of colonization, eradication prior to surgery, and subsequent development of SSI in the year after surgery. SSI was defined according to the criteria established by the Centers for Disease Control and Prevention.