Letter to the Editor

Verhoeven, Paul; Berthelot, Philippe; Chapelle, Céline; Gagnaire, Julie; Grattard, Florence; Pozzetto, Bruno; Farizon, Frédéric; Lucht, F.; Botelho-Nevers, Élisabeth

doi:10.1007/s11999-013-3254-6

Cited by 11 publications

(2 citation statements)

References 8 publications

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“…In fact, nasal povidone-iodine was shown to be equally effective when compared to mupirocin in preventing deep S. aureus SSI 35 . Nevertheless, the World Health Organization (WHO) strongly recommends using mupirocin 2% for treating known nasal carriers, while they give no recommendation for or against the use of a chlorhexidine body wash for the purpose of decolonization 36 . For our study, we finally decided to follow the recommendations of the WHO.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, in these studies the protocol also saved costs when comparing the costs of screening and decolonization with the reduction of SSI 13 . However, other authors using the same screening and decolonization protocol have observed a decrease in S. aureus SSI which was not statistically significant, and they concluded that no clear benefit could be demonstrated using the protocol, and recommended performing a mega-trial investigating the efficiency and cost-effectiveness of a decolonization strategy in nasal S. aureus carriers 3, 11, 35, 36…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Reduction of periprosthetic Staphylococcus aureus infection by preoperative screening and decolonization of nasal carriers undergoing total knee arthroplasty

Pelfort

Alba

Brugués

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveThe aim of this study was to evaluate whether the establishment of a preoperative screening and decolonization protocol for Staphylococcus aureus carriers undergoing total knee arthroplasty (TKA) could decrease the incidence of periprosthetic joint infection (PJI) caused by this microorganism.MethodsWe conducted a retrospective study comparing a control group comprising 400 patients (134 men, and 266 women; mean age: 72.2 ± 6.8 years) who went through surgery between January 2009 and December 2013, with a second intervention group of 403 patients (125 men, and 278 women; mean age: 72.4 ± 6.9 years) in which the protocol of screening and decolonization of S. aureus nasal carriers was applied between January 2014 and December 2016. During this latter period patients were preoperatively screened and, if positive, treated with mupirocin nasal ointment and chlorhexidine soap, for 5 days prior to surgery.ResultsIn the control group, 17 of 400 patients (4.2%) had a SSI, 8 (2%) of them caused by S. aureus and 9 (2.2%) by other microorganisms. In the intervention group 20.6% of patients had a positive S. aureus nasal swab and were treated according to the protocol. 5 of 403 patients (1.2%) in this group had a SSI, 1 (0.2%) due to S. aureus and 4 (1%) to other microorganisms. When comparing surgical-site infection (SSI) rates between the two groups, we found a statistically significant reduction in both global SSI (p = 0.009) and specifically S. aureus SSI (p = 0.02), in the intervention group. No decolonized S. aureus nasal carrier presented a SSI.DiscussionIn patients undergoing TKA a preoperative screening and decolonization protocol for S. aureus nasal carriers, using mupirocin nasal ointment and chlorhexidine soap, is an effective measure to reduce the rate of SSI caused by this microorganism.Level of EvidenceLevel III; Therapeutic Study.

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Section: Discussionmentioning

confidence: 99%