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

Yano, Koichi; Minoda, Yukihide; Sakawa, Akira; Kuwano, Yoshihiro; Kondo, Kyoko; Fukushima, Wakaba; Tada, Koichi

doi:10.3109/17453670903110675

Cited by 77 publications

(39 citation statements)

References 31 publications

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“…In our study, we found that admission 24 hours or more before surgery increases the incidence of infection and should be avoided in those cases that are not emergent or semiurgent (OR, 7.09; 95% CI, 3.93-12.7; p \ 0.001). Positive nasal screening for S aureus including methicillin-resistant S aureus was found to increase PJI in previous studies [14,24]. Our data show similar findings.…”

Section: Staphylococcus Aureus 15supporting

confidence: 82%

The Otto Aufranc Award: Modifiable versus Nonmodifiable Risk Factors for Infection After Hip Arthroplasty

Maoz

Phillips

Bosco

et al. 2015

Clinical Orthopaedics &Amp; Related Research

162

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Background Periprosthetic joint infections (PJIs) are associated with increased morbidity and cost. It would be important to identify any modifiable patient-and surgicalrelated factors that could be modified before surgery to decrease the risk of PJI. Questions/purposes We sought to identify and quantify the magnitude of modifiable risk factors for deep PJIs after primary hip arthroplasty. Methods A series of 3672 primary and 406 revision hip arthroplasties performed at a single specialty hospital over a 3-year period were reviewed. All deep PJIs were identified using the Centers for Disease Control and Prevention case definitions (ie, occurs within 30-90 days postoperatively, involves deep soft tissues of the incision, purulent drainage, dehiscence and fever, localized pain or tenderness). Univariate and multivariate analyses determined the association between patient and surgical risk factors and PJIs. For the elective patients, the procedure was performed on the day of admission (''same-day procedure''), whereas for the fracture and nonelective patients, the procedure was performed 1 or more days postadmission (''nonsame-day procedure''). Staphylococcus aureus colonization, tobacco use, and body mass index (BMI) were defined as patient-related modifiable risk factors. Results Forty-seven (1.3%) deep PJIs were identified. Infection developed in 20 of 363 hips of nonsame-day procedures and 27 of 3309 same-day procedures (p = 0.006). There were eight (2%) infections in the revision group. After controlling for confounding variables, our multivariate analysis showed that BMI 3 40 kg/m 2 (odds ratio [OR], 4.13; 95% confidence interval [CI], 1.3-12.88; p = 0.01), operating time [ 115 minutes (OR, 3.38; 95% CI, 1.23-9.28; p = 0.018), nonsame-day surgery (OR, 4.16; 95% CI, 1.44-12.02; p = 0.008), and revision surgery (OR, 4.23; 95% CI, 1.67-10.72; p \ 0.001) are significant risk factors for PJIs. Tobacco use and S aureus colonization were additive risk factors when combined with other significant risk factors (OR, 12.76; 95% CI,; p = 0.017). Conclusions Nonsame-day hip and revision arthroplasties have higher infection rates than same-day primary surgeries. These characteristics are not modifiable and should be categorized as a separate cohort for complication-reporting purposes. Potentially modifiable risk factors in our patient population include operating time, elevated BMI, tobacco use, and S aureus colonization. Modifying risk factors may

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Section: Staphylococcus Aureus 15supporting

confidence: 82%

The Otto Aufranc Award: Modifiable versus Nonmodifiable Risk Factors for Infection After Hip Arthroplasty

Maoz

Phillips

Bosco

et al. 2015

Clinical Orthopaedics &Amp; Related Research

162

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“…Infection spreads in hospitals because of close contact and the point that hospitals staff and patients carry antibiotic resistant S. aureus specially (MRSA) in their nose or on their skin [3,4,17].…”

Section: Discussionmentioning

confidence: 99%

“…Staphylococci, especially Staphylococcus epidermidis, are part of the normal flora of human skin, and gastrointestinal and respiratory tracts. S. aureus is the most significant pathogen of human infections, mainly wound, respiratory tract and skin infections that is associated with several pathological processes such as food poisoning, pneumonia, bacteremia, folliculitis, and osteomyelitis [2][3][4]. This organism is one of the most important causes of nosocomial infections, which become increasingly more resistant against the antibiotics of beta-lactam and vancomycin groups [5,6].…”

Section: Introductionmentioning

confidence: 99%

Relationship between Antibiotic Resistance Patterns and Coagulase in Clinical Isolates of Staphylococcus aureus in Nowshahr and Chalous

Sajadi

Kaboosi

Ghadikolii

2017

Zahedan J Res Med Sci

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Background: Staphylococcus aureus is one of the main agents of nosocomial infections. Identifying coagulase enzyme in staphylococcal infections is of great importance as it is one of the main virulence agents. The present study aims to accurately detect the presence of coagulase gene and its relationship with antibiotic resistance patterns in clinical isolates. Methods: In this experimental study, a total of 20 clinical samples of S. aureus and 10 clinical samples of coagulase-negative staphylococci were collected and identified from hospitals and laboratories in Nowshahr and Chalous. Antibiotic resistance patterns of isolates were examined based on CLSI and finally polymerase chain reaction was used in order to detect the presence of coagulase gene with specific primers. Treatments were examined in three intervals and the results were analyzed using one-way analysis of variance (ANOVA), univariate ANOVA, and t-test at the probability level of P < 0.05. Moreover, the comparison of means was presented using Duncan's multiple range tests (P < 0.05). All the statistical analyses were carried out using SPSS (V. 16). Results: Suggested that isolates showed phenotypic presence of coagulase enzyme and had this gene genotypically as well. Coagulase-positive samples demonstrated higher resistance to tetracycline 20%, oxacillin 55%, gentamicin 20%, and kanamycin 25%. Statistically, there was no significant difference among inhibition zone diameters of oxacillin, nalidixic acid, gentamicin, kanamycin, and penicillin. Conclusions: Coagulase gene causes antibiotic resistance and coagulase-negative staphylococci are spreading rapidly and their resistance is increasing.

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“…Yano et al 9 reported that positive nasal culture of MRSA is a risk factor for SSI in elective orthopaedics. Of 2423 patients included in the study, 63 (2.6%) were nasal MRSA carriers.…”

Section: Discussionmentioning

confidence: 99%

Surgical site infection risk following pre-operative MRSA detection in elective orthopaedic surgery

Akhtar

Kadir

Chandran

2014

Journal of Orthopaedics

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

Cited by 77 publications

References 31 publications

The Otto Aufranc Award: Modifiable versus Nonmodifiable Risk Factors for Infection After Hip Arthroplasty

The Otto Aufranc Award: Modifiable versus Nonmodifiable Risk Factors for Infection After Hip Arthroplasty

Relationship between Antibiotic Resistance Patterns and Coagulase in Clinical Isolates of Staphylococcus aureus in Nowshahr and Chalous

Surgical site infection risk following pre-operative MRSA detection in elective orthopaedic surgery

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