Use of perioperative mupirocin to prevent methicillin-resistant Staphylococcus aureus (MRSA) orthopaedic surgical site infections

Wilcox, Mark H.; Hall, James A.; Pike, Harriet; Templeton, Peter; Fawley, Warren N.; Parnell, P.; Verity, P

doi:10.1016/s0195-6701(03)00147-6

Cited by 148 publications

(112 citation statements)

References 19 publications

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“…2B) [5,9,16,19,42,51], the reduction of MRSA SSIs ranged from 29% to 149% (Fig. 2C) [9,29,36,40,49,57], and the reduction of wound complications was reported at 4% in one study [7]. Although all studies that were included showed reductions in SSIs with use of a decolonization protocol, not all reductions were statistically significant [20,26,29,36,49].…”

Section: Resultsmentioning

confidence: 96%

“…aureus detection was performed by PCR in four studies [5,19,30,40], culture in 13 studies [7,9,11,16,20,24,26,29,36,42,43,49,57], mixed methods of detection in one aggregate study [51], and unknown in one study [47]. Fifteen of the studies reported SSI reductions when only S. aureuspositive screened patients were decolonized, and eight studies [9,11,16,20,26,36,51,57] reported decreases in Table 2. SSIs when all patients were decolonized.…”

Section: Resultsmentioning

confidence: 99%

“…SSIs when all patients were decolonized. Regarding the method of decolonization, six studies exclusively used mupirocin [9,11,16,24,26,51], 10 used mupirocin and chlorhexidine [5,7,19,20,29,30,40,42,43,49], and three used mupirocin and triclosan [36,47,57] ( Table 2). The range of SSI reduction varied among groups; studies that used mupirocin showed only 29% to 57% reductions in total SSIs; studies that used mupirocin and chlorhexidine showed 13% to 81% reductions in total SSIs, 56% to 200% reductions in S. aureus SSIs, and 29% to 100% reductions in MRSA SSIs; and studies that used mupirocin and triclosan showed a 200% reduction in total SSIs and 56% to 149% reductions in MRSA SSIs.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 19 studies that evaluated the ability of S. aureus screening and decolonization to reduce SSI in orthopaedic patients, there were nine prospective studies [5,26,30,42,43,47,49,51,57] and 10 retrospective studies [7,9,11,16,19,20,24,29,36,40] (Table 1). Most studies evaluating S. aureus screening and decolonization in orthopaedic patients were conducted on patients undergoing elective total joint arthroplasty [11,16,19,20,25,30,42,43,47,49], although many studies did evaluate all elective orthopaedic patients [5,9,24,29,36,40,51,57], spine patients [7,30], and trauma patients [36].…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

“…Most studies evaluating S. aureus screening and decolonization in orthopaedic patients were conducted on patients undergoing elective total joint arthroplasty [11,16,19,20,25,30,42,43,47,49], although many studies did evaluate all elective orthopaedic patients [5,9,24,29,36,40,51,57], spine patients [7,30], and trauma patients [36]. The majority of studies detected S. aureus colonization using cultures, most SSIs were defined by CDC criteria, the majority of studies did not differentiate between superficial versus deep infections, and most of the patients who underwent decolonization were positive for S. aureus on nasal screens ( Table 2).…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

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Staphylococcus aureus Screening and Decolonization in Orthopaedic Surgery and Reduction of Surgical Site Infections

Chen

Wessel

Rao

2013

Clinical Orthopaedics &Amp; Related Research

170

100

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Search Strategy and Criteriamentioning

confidence: 99%

Section: Search Strategy and Criteriamentioning

confidence: 99%

See 3 more Smart Citations

Staphylococcus aureus Screening and Decolonization in Orthopaedic Surgery and Reduction of Surgical Site Infections

Chen

Wessel

Rao

2013

Clinical Orthopaedics &Amp; Related Research

170

100

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Methicillin-Resistant Staphylococcus aureus–Positive Surgical Site Infections in Face-lift Surgery

Zoumalan

Rosenberg

2008

Archives of Facial Plastic Surgery

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To determine the incidence of methicillinresistant Staphylococcus aureus (MRSA)-positive surgical site infections after face-lift surgery and to discuss the screening, prevention, and treatment of such infections. Methods: The patient charts of 780 patients who underwent a deep-plane rhytidectomy between 2001 and 2007 were reviewed for postoperative wound infections. Culture results and sensitivities were recorded. To our knowledge, this is the first study that documents MRSA-positive surgical site infections after face-lift surgery. Results: Five of 780 patients (0.6%) who underwent facelift surgery by the senior surgeon had postoperative surgical site infections. Four of the 5 patients had cultures that were positive for MRSA. Two of these patients (0.3%) required hospitalization and had collections that had to be opened or drained and developed wound breakdown. Both patients eventually responded to wound care along with intravenous and then oral antibiotic therapy. The other 2 MRSA-infected patients responded to oral antibiotic therapy and local wound care alone. The 2 complicated infections occurred on postoperative days 5 and 8. These 2 patients were the only ones among the 5 patients with positive cultures who had known recent contact with another physician or a hospital. All infections occurred in the year 2006, with 3 patients experiencing infection in the last 4 months of the year. Herein, we describe the incidence and sequelae of MRSA infections and colonization. The 2 major different subsets of MRSA are community-acquired MRSA and health care-associated MRSA. Surgical site infections that are positive for MRSA blur this division, which affects many aspects of the course of disease and treatment. We also discuss strategies for screening, preventing, and treating MRSA surgical site infections. Conclusions: Methicillin-resistant S aureus-positive surgical site infection is an increasingly problematic issue in all surgical fields. In the future, MRSA-positive infections will be more prevalent and will require well-developed screening, prevention, and treatment strategies.

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Preoperative bathing or showering with skin antiseptics to prevent surgical site infection

Webster

Osborne

2006

Cochrane Database of Systematic Reviews

117

124

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Use of perioperative mupirocin to prevent methicillin-resistant Staphylococcus aureus (MRSA) orthopaedic surgical site infections

Cited by 148 publications

References 19 publications

Staphylococcus aureus Screening and Decolonization in Orthopaedic Surgery and Reduction of Surgical Site Infections

Staphylococcus aureus Screening and Decolonization in Orthopaedic Surgery and Reduction of Surgical Site Infections

Methicillin-Resistant Staphylococcus aureus–Positive Surgical Site Infections in Face-lift Surgery

Preoperative bathing or showering with skin antiseptics to prevent surgical site infection

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