Association between methicillin-resistant Staphylococcus pseudintermedius carriage and the development of surgical site infections following tibial plateau leveling osteotomy in dogs

Nazarali, Alim; Singh, Ameet; Moens, Noël M. M.; Gatineau, Matthieu; Sereda, Colin W.; Fowler, David; Kim, Stanley E.; Kisiel, Agatha; Reynolds, Debbie; Ringwood, Brendon R.; Bruce, Charles W.; Gibson, Thomas W.G.; Rousseau, Joyce D.; Weese, J. Scott

doi:10.2460/javma.247.8.909

Cited by 44 publications

(49 citation statements)

References 38 publications

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“…We did not find a benefit with the use of postoperative antibiotics for the prevention of SSI after TTA. This is both in contrast to and in agreement with other reports of studies that evaluated the benefit of postoperative antibiotics at reducing the occurrence of SSI in proximal tibial osteotomy …”

Section: Discussionsupporting

confidence: 92%

“…This is both in contrast to and in agreement with other reports of studies that evaluated the benefit of postoperative antibiotics at reducing the occurrence of SSI in proximal tibial osteotomy. 9,11,[22][23][24] The most common type of bacteria cultured was Staphylococcus spp, which is similar to findings in previously reported studies. 4,9,10,13,14 When we evaluated the cases that required implant removal for infection resolution, almost half cultured positive for oxacillin-resistant Staphylococcus bacteria.…”

Section: Serratia Sppsupporting

confidence: 90%

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Impact of postoperative antibiotics on rates of infection and implant removal after tibial tuberosity advancement in 1,768 canine stifles

Ferrell¹,

Barnhart²,

Herman³

2019

Veterinary Surgery

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Objective To report infection rate, implant removal rate, and postoperative antibiotic therapy after tibial tuberosity advancement (TTA) in dogs. Study design Retrospective study. Animals One thousand seven hundred sixty‐eight stifles in 1,732 dogs. Methods Medical records (January 2007‐December 2011) of dogs treated with a TTA were reviewed. Cases were included if at least 1 year of postoperative follow‐up was available and no additional procedures were performed on the stifle. Date of surgery, date of culture, culture and susceptibility results, postoperative antimicrobials used, and any implant removals were recorded. Use of postoperative antibiotics and implant removal were evaluated statistically for effect on infection occurrence and resolution. Results Postoperative infections were diagnosed in 82 of 1,768 (4.6%) stifles. Implants were removed from 32 (39%) stifles, with plate and screw removal only in 23 (71.9%) stifles. The rate of infection did not differ between dogs with or without postoperative antibiotic therapy. However, dogs receiving postoperative antibiotic therapy were at risk for developing an oxacillin‐resistant infection (P = .001). Oxacillin‐resistant infections were associated with a requirement for implant removal to achieve resolution compared with other types of bacterial infections (P < .05). Conclusion No benefit was detected with the use of postoperative antibiotics after TTA in this population. Implant removal was infrequent, and the requirement for cage removal was not commonly required for infection resolution. Clinical significance This study does not provide evidence to support postoperative antibiotic therapy after TTA. Postoperative infection can be treated in most dogs without removal of the TTA cage.

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Section: Discussionsupporting

confidence: 92%

Section: Serratia Sppsupporting

confidence: 90%

Impact of postoperative antibiotics on rates of infection and implant removal after tibial tuberosity advancement in 1,768 canine stifles

Ferrell¹,

Barnhart²,

Herman³

2019

Veterinary Surgery

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“…19,[23][24][25] Contradictory findings, however, have been reported. Several reports of recent studies involving dogs undergoing TPLO have described a reduced risk of postoperative infection with the use of postoperative antibiotic therapy, [3][4][5]8,10,[12][13][14][15]26 while other reports have described findings that postoperative antibiotic therapy did not result in a significant reduction in SSI. 6,7,27,28 However, the only two studies in which dogs weighing >50 kg were assessed provided evidence of a protective effect of the use of postoperative antimicrobial treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies provided evidence that high body weight was significantly associated with an increase in overall TPLO complication rate and that use of postoperative antibiotic therapy had a protective effect against SSI . Large dogs seem to be highly susceptible to developing SSI after TPLO (with infection rates of 21.3%‐25.9% reported for dogs weighing >50 kg) .…”

Section: Introductonmentioning

confidence: 99%

“…9 Several studies provided evidence that high body weight was significantly associated with an increase in overall TPLO complication rate 5,7,10,11 and that use of postoperative antibiotic therapy had a protective effect against SSI. [3][4][5]8,10,[12][13][14][15] Large dogs seem to be highly susceptible to developing SSI after TPLO (with infection rates of 21.3%-25.9% reported for dogs weighing >50 kg). 4,8 One previous study provided evidence that the use of locking plate and screw fixation significantly reduced the infection rate compared with nonlocking constructs.…”

mentioning

confidence: 99%

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Risk of infection after double locking plate and screw fixation of tibial plateau leveling osteotomies in dogs weighing greater than 50 kilograms

Tuan¹,

Solano²,

Danielski

2019

Veterinary Surgery

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Objective To compare surgical site infection (SSI) rates after double locking plate and screw fixation (DLP), standard locking plate and screw fixation (LP), and conventional nonlocking plate and screw fixation (NLP) in dogs weighing >50 kg undergoing tibial plateau leveling osteotomy (TPLO). Study design Retrospective study (January 2003‐October 2017). Animals Two hundred seventy‐five dogs weighing >50 kg with cranial cruciate ligament disease treated with TPLO. Methods Medical records of dogs weighing >50 kg that underwent TPLO by DLP, LP, and NLP with a minimum follow‐up period of 12 months were included. Data collected included signalment, details of any concurrent surgical procedure, type of implant used, use of postoperative antibiotic therapy, occurrence of perioperative complications, and presence of postoperative infection. The probability, risk difference, and relative risk of SSI were estimated for each fixation with a marginal model. Results Nonlocking plate and screw fixation was used in 114 (41.5%) dogs, LP was used in 128 (46.5%) dogs, and DLP was used in 33 (12%) dogs. Surgical site infection was diagnosed in 48 of 275 (17.5%) dogs. Postoperative antibiotic therapy was used in 74 (64.9%) dogs, 62 (48.4%) dogs, and 32 (97.0%) dogs in the NLP, LP, and DLP groups, respectively. Dogs with NLP, LP, and DLP had postoperative infection rates of 24.5%, 13.3%, and 9.1%, respectively. There were no risk differences for the three groups (Holm‐adjusted P > .05). Conclusion No difference in infection rates was detected between DLP, LP, or NLP for TPLO in these dogs weighing >50 kg. Clinical significance Fixation of TPLO with DLP in dogs weighing >50 kg does not seem to increase the risk of SSI compared with LP and NLP.

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Tibial Plateau Leveling Osteotomy

Schaefer

2017

Advances in the Canine Cranial Cruciate Ligament

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Association between methicillin-resistant Staphylococcus pseudintermedius carriage and the development of surgical site infections following tibial plateau leveling osteotomy in dogs

Abstract: Results indicated that carriage of MRSP were a risk factor for development of an SSI after TPLO and measures to rapidly identify and treat MRSP carriers are warranted. Postoperative administration of antimicrobials protected against development of an SSI after TPLO.

Cited by 44 publications

References 38 publications

Impact of postoperative antibiotics on rates of infection and implant removal after tibial tuberosity advancement in 1,768 canine stifles

Impact of postoperative antibiotics on rates of infection and implant removal after tibial tuberosity advancement in 1,768 canine stifles

Risk of infection after double locking plate and screw fixation of tibial plateau leveling osteotomies in dogs weighing greater than 50 kilograms

Tibial Plateau Leveling Osteotomy

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