Predictors of colonization with Staphylococcus species among patients scheduled for cardiac and orthopedic interventions at tertiary care hospitals in north-eastern Germany—a prevalence screening study

Neidhart, S.; Zaatreh, Sarah; Klinder, Annett; Redanz, Sylvio; Spitzmüller, Romy; Holtfreter, Silva; Warnke, Philipp; Alozie, Anthony; Henck, Vivien; Göhler, André; Ellenrieder, Martin; Aboukoura, M.; Divchev, Dimitar; Gümbel, Denis; Napp, Matthias; Steinhoff, Gustav; Nienaber, Christoph; Mittelmeier, Wolfram; Güthoff, Claas; Podbielski, Andreas; Stengel, Dirk; Bader, Rainer

doi:10.1007/s10096-017-3154-x

Cited by 15 publications

(13 citation statements)

References 48 publications

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“…When examining different surgical categories, we were able to demonstrate that SSI-rates were significantly higher in men undergoing orthopedic and trauma procedures. A prevalence study investigating predictors of colonization with Staphylococcus species in patients undergoing cardiac and orthopedic surgery found significantly higher colonization rates in men [13]. With Staphylococcus aureus being the most common SSI-causing pathogen, it is conceivable that this disparity in colonization patterns could partially explain the gender-related differences in SSI-rates.…”

Section: Discussionmentioning

confidence: 99%

Gender-related risk factors for surgical site infections. Results from 10 years of surveillance in Germany

Aghdassi

Schröder

Gastmeier

2019

Antimicrob Resist Infect Control

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Background Surgical site infections (SSI) are among the most frequently occurring healthcare-associated infections worldwide. Various analyses to determine risk factors have been conducted in the past, generally attributing a higher SSI-risk to male patients. However, when focusing on specific procedures, this is not always true. Our objective was to identify for which procedures male or female sex represents an independent risk factor for SSI and which parameters may explain these differences. Methods We used the database of surgical procedures from the German national nosocomial infection surveillance system. We included procedures conducted between 2008 and 2017. We excluded procedures solely executed for one sex (e.g. mastectomy) and procedures with 20,000 or fewer operations. The observed outcome was the occurrence of SSI. All models were adjusted for confounders, which were eliminated with backward selection. The following factors were included in the analysis: age, ASA score, wound contamination class, duration of surgery, and season. All models contained the investigated factor sex. Results Sixteen procedure types with 1,266,782 individual procedures and 18,824 SSI were included. Overall, the incidence rate ratio and the adjusted odds ratio for SSI were significantly higher for male patients. The included individual procedures were grouped into five surgical categories. For orthopedics and traumatology as well as abdominal surgery, SSI-rates were significantly higher for male patients. For heart and vascular surgery, SSI-rates were significantly higher for female patients. Other included surgical categories and individual procedures yielded diverse results. Similar results were found when solely analyzing deep and organ-space SSI. Multivariable analysis for attributable gender-related risk factors revealed differences with regard to underlying risk factors. Conclusions SSI-rates differ by sex for certain procedures. When examining underlying risk factors, differences between male and female patients can be demonstrated. Our analysis considered a limited number of parameters, which were not sufficient to fully explain the observed differences. Further studies are required to obtain a more comprehensive understanding of the topic and to include gender-specific aspects into future SSI-prevention strategies. Electronic supplementary material The online version of this article (10.1186/s13756-019-0547-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Gender-related risk factors for surgical site infections. Results from 10 years of surveillance in Germany

Aghdassi

Schröder

Gastmeier

2019

Antimicrob Resist Infect Control

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“…There is a huge difference in the epidemiology of MRSA worldwide. For example, the prevalence of community-associated MRSA infection in Japan, Germany, Turkey, Taiwan, and Malta was found to be 0.94% [29], 1.2% [17], 1.2% [30], 3.8% [31], and 8.81% [6] respectively. These differences can be attributed to variations in microbiological methods (sampling technique, culture sites, and method of MRSA identification), local infection control standards, and the local prevalence of MRSA.…”

Section: Discussionmentioning

confidence: 99%

“…However, obesity did not turn out to be a significant risk factor for MRSA colonization in this study. Neidhart et al [17] reported a reduced risk for S. aureus carriage in obese (BMI ≥ 30.0 kg/m 2 ) compared to overweight patients (BMI of 25.0 to 30 kg/m 2 ). However, other studies reported the opposite result.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and Risk Factors for Positive Nasal Methicillin-Resistant Staphylococcus aureus Carriage among Orthopedic Patients in Korea

Choi

Lee

Kim

et al. 2019

JCM

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Methicillin-resistant Staphylococcus aureus (MRSA) causes purulent skin and soft tissue infections as well as other life-threatening diseases. Recent guidelines recommend screening for MRSA at the time of admission. However, few studies have been conducted to determine the prevalence and risk factors for MRSA colonization. A prospective data collection and retrospective analysis was performed. MRSA screening tests were performed using nasal swabs in patients enrolled between January 2017 and July 2018. Demographic data, socio-economic data, medical comorbidities, and other risk factors for MRSA carriage were evaluated among 1577 patients enrolled in the study. The prevalence of MRSA nasal carriage was 7.2%. Univariate regression analysis showed that colonization with MRSA at the time of hospital admission was significantly related to patient age, body mass index, smoking, alcohol, trauma, recent antibiotic use, and route of hospital admission. Multiple logistic regression analysis for the risk factors for positive MRSA nasal carriage showed that being under- or overweight, trauma diagnosis, antibiotic use one month prior to admission, and admission through an emergency department were related to MRSA colonization. This study highlights the importance of a preoperative screening test for patients scheduled to undergo surgery involving implant insertion, particularly those at risk for MRSA.

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“…For example, the prevalence of communityassociated MRSA infection in Japan, Germany, Turkey, Taiwan, and Malta was found to be 0.94%, 1.2%, 1.2%, 1 3.8%, 1 and 8.81% 1 respectively. [8][9][10][11][12] This variation of nasal carriage rate of S. aureus in studies might be due to difference in the characteristics of the study population, quality of sampling, culturing techniques, geographical distribution, and diagnostic techniques. 13 A previous study reported an MRSA colonization rate in diabetics as 10.2%, whereas in another study it was 19% in diabetics on hemodialysis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of nasal carriage of MRSA in diabetic patients attending the outpatient department

et al. 2020

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Background: Up to 30% of the human population is asymptomatically colonized with nasal Staphylococcus aureus. Study was done to determine the prevalence and risk factors for MRSA colonization as nasal carrier in a population of outpatients with diabetes.Methods: The study enrolled patients with diabetes from whom nasal swabs were obtained and were analyzed for presence of MRSA.Results: Out of the 402 patients evaluated, 254 (63.18%) were colonized with S. aureus and 164 (64.56%) of them were MRSA.Conclusions: Diabetes have more propensity for MRSA colonization than non-diabetic patients. A better understanding of the epidemiology and risk factors for nasal MRSA colonization in the persons with diabetes may have significant implications for the treatment and prevention of MRSA infections.

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Predictors of colonization with Staphylococcus species among patients scheduled for cardiac and orthopedic interventions at tertiary care hospitals in north-eastern Germany—a prevalence screening study

Cited by 15 publications

References 48 publications

Gender-related risk factors for surgical site infections. Results from 10 years of surveillance in Germany

Gender-related risk factors for surgical site infections. Results from 10 years of surveillance in Germany

Prevalence and Risk Factors for Positive Nasal Methicillin-Resistant Staphylococcus aureus Carriage among Orthopedic Patients in Korea

Prevalence of nasal carriage of MRSA in diabetic patients attending the outpatient department

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