2018
DOI: 10.1590/1414-431x20176736
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Abstract: Staphylococcus aureus colonization in the nares of patients undergoing elective orthopedic surgery increases the potential risk of surgical site infections. Methicillin-resistant S. aureus (MRSA) has gained recognition as a pathogen that is no longer only just a hospital-acquired pathogen. Patients positive for MRSA are associated with higher rates of morbidity and mortality following infection. MRSA is commonly found in the nares, and methicillin-sensitive S. aureus (MSSA) is even more prevalent. Recently, st… Show more

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Cited by 19 publications
(12 citation statements)
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“…If they are positive, we recommend that they undergo application of mupirocin nasal ointment twice daily to both nares and bathe with chlorhexidine daily for 5 days immediately prior to the scheduled surgery. Alternatively, patients can also be treated with nasal povidone-iodine swabs which have demonstrated reduction in the colonization of S. aureus [45]. In addition, patients who screen positive for MRSA should also receive a single dose of vancomycin along with standard perioperative antibiotics.…”
Section: Staphylococcus Aureus Screeningmentioning
confidence: 99%
“…If they are positive, we recommend that they undergo application of mupirocin nasal ointment twice daily to both nares and bathe with chlorhexidine daily for 5 days immediately prior to the scheduled surgery. Alternatively, patients can also be treated with nasal povidone-iodine swabs which have demonstrated reduction in the colonization of S. aureus [45]. In addition, patients who screen positive for MRSA should also receive a single dose of vancomycin along with standard perioperative antibiotics.…”
Section: Staphylococcus Aureus Screeningmentioning
confidence: 99%
“…According to a U.S. cost-effectiveness model, universal preoperative decolonization with intranasal PVP-I in patients undergoing orthopedic surgery potentially saved $74.42 per patient compared to preoperative screening and treatment of MRSApositive patients with a 5-day course of intranasal mupirocin (77). Other studies conducted in different settings led to a similar conclusion, i.e., systemic preoperative decolonization with PVP-I was more cost-effective than the standard MRSA screening protocol in orthopedic surgery, with no difference in infection rates (74,78).…”
mentioning
confidence: 92%
“…Patients undergoing orthopedic surgery who had tested positive for methicillin-sensitive staphylococcus aureus (MSSA) or methicillin-resistant staphyloccocus aureus (MRSA) nasal colonization were treated with 5% PVP-I in both nostrils twice daily for 5 days prior to surgery. 27 This completely eradicated MRSA in all patients and reduced rate of MSSA infection by 94%. Another study used 5% PVP-I solution the night before and morning of surgery for hardware implantation and noted a significantly lower rate of surgical site infection (SSI) in the treatment group.…”
Section: Resultsmentioning
confidence: 96%