Surgical site infections following hip and knee arthroplastic surgery: Trends and risk factors of <i>Staphylococcus aureus</i> infections

Prattingerová, Jana; Sarvikivi, Emmi; Huotari, Kaisa; Ollgren, Jukka; Lyytikäinen, Outi

doi:10.1017/ice.2018.312

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…The patient characteristics in the North control group were different as compared to those of the South group, in particular in terms of Altemeier classification, ASA scores, lengths of surgery, and proportion of surgical procedures for osteosyntheses, but North/South site variable was not included in the multivariate analysis because it did not modify the significance of the result. These results are coherent with those of literature; an analysis of 3,618 S. aureus SSI after knee and hip prosthesis procedures [ 31 ] found the following risk factors: male gender, length of surgery >120 minutes, ASA score ≥2 and hip prosthesis replacement. Diabetes, smoking, nasal carriage of S. aureus , cancer, the NNIS score and the BMI were also risk factors found in some orthopaedic surgery studies [ 9 , 32 , 33 ].…”

Section: Discussionsupporting

confidence: 91%

Staphylococcus aureus screening and preoperative decolonisation with Mupirocin and Chlorhexidine to reduce the risk of surgical site infections in orthopaedic surgery: a pre-post study

Portais,

Gallouche,

Pavese

et al. 2024

Antimicrob Resist Infect Control

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Background Nasal carriage of Staphylococcus aureus is a risk factor for surgical site infections (SSI) in orthopaedic surgery. The efficacy of decolonisation for S. aureus on reducing the risk of SSI is uncertain in this speciality. The objective was to evaluate the impact of a nasal screening strategy of S. aureus and targeted decolonisation on the risk of S. aureus SSI. Methods A retrospective pre-post and here-elsewhere study was conducted between January 2014 and June 2020 in 2 adult orthopaedic surgical sites (North and South) of a French university hospital. Decolonisation with Mupirocin and Chlorhexidine was conducted in S. aureus carriers starting February 2017 in the South site (intervention group). Scheduled surgical procedures for hip, knee arthroplasties, and osteosyntheses were included and monitored for one year. The rates of S. aureus SSI in the intervention group were compared to a historical control group (South site) and a North control group. The risk factors for S. aureus SSI were analysed by logistic regression. Results A total of 5,348 surgical procedures was included, 100 SSI of which 30 monomicrobial S. aureus SSI were identified. The preoperative screening result was available for 60% (1,382/2,305) of the intervention group patients. Among these screenings, 25.3% (349/1,382) were positive for S. aureus and the efficacy of the decolonisation was 91.6% (98/107). The rate of S. aureus SSI in the intervention group (0.3%, 7/2,305) was not significantly different from the historical control group (0.5%, 9/1926) but differed significantly from the North control group (1.3%, 14/1,117). After adjustment, the risk factors of S. aureus SSI occurrence were the body mass index (ORaper unit, 1.05; 95%CI, 1.0-1.1), the Charlson comorbidity index (ORaper point, 1.34; 95%CI, 1.0–1.8) and operative time (ORaper minute, 1.01; 95%CI, 1.00–1.02). Having benefited from S. aureus screening/decolonisation was a protective factor (ORa, 0.24; 95%CI, 0.08–0.73). Conclusions Despite the low number of SSI, nasal screening and targeted decolonisation of S. aureus were associated with a reduction in S. aureus SSI.

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Section: Discussionsupporting

confidence: 91%

Staphylococcus aureus screening and preoperative decolonisation with Mupirocin and Chlorhexidine to reduce the risk of surgical site infections in orthopaedic surgery: a pre-post study

Portais,

Gallouche,

Pavese

et al. 2024

Antimicrob Resist Infect Control

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“…Periprosthetic joint infections still represent a challenge in medical practice, from early diagnosis, identification of causative pathogens, and proper management. 4,5 Although there are several clinical guidelines associated with the prevention of peri-and postoperative complications, it is observed that such normative divergence causes high rates of clinical variation in the management of patients undergoing hip arthroplasties, also resulting in different clinicians.…”

Section: Introductionmentioning

confidence: 99%

“…As IAPs representam ainda um desafio na prática médica desde o seu diagnóstico precoce, identificação dos patógenos causadores e manejo adequado. 4,5 Embora existam diversas diretrizes clínicas associadas à prevenção de complicações peri-e pós-operatórias, observase que tal divergência normativa ocasiona altas taxas de variações no manejo de pacientes submetidos a artroplastias de quadril, resultando também em diferentes desfechos clínicos.…”

Section: Introductionunclassified

“…Periprosthetic joint infections still represent a challenge in medical practice, from early diagnosis, identification of causative pathogens, and proper management. 4 5 …”

Section: Introductionmentioning

confidence: 99%

“…As IAPs representam ainda um desafio na prática médica desde o seu diagnóstico precoce, identificação dos patógenos causadores e manejo adequado. 4 5 …”

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Diagnóstico e prevenção de infecções articulares periprotéticas por Staphylococcus aureus após fratura de quadril: Revisão sistemática de literatura

Oliveira,

Costa,

Gama

et al. 2024

Rev Bras Ortop (Sao Paulo)

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ResumoAs artroplastias de quadril são procedimentos cirúrgicos largamente realizados em todo o mundo buscando retorno da funcionalidade, alívio da dor e melhora da qualidade de vida dos pacientes acometidos por quadros de osteoartrite, fraturas de colo de fêmur e osteonecrose da cabeça femoral, dentre outras etiologias. As infecções articulares periprotéticas são uma das complicações mais temidas pela elevada morbimortalidade associada, com elevado número de patógenos que podem estar associados à sua etiologia. O objetivo do presente estudo foi analisar aspectos correlacionados à ocorrência da infecção, diagnóstico e prevenção de infecções articulares periprotéticas no quadril associadas a Staphylococcus aureus após cirurgia corretiva de fraturas de quadril. Trata-se de uma revisão sistemática de literatura realizada nas bases de dados indexadas na Medical Literature Analysis and Retrieval System Online (MEDLINE, na sigla em inglês) realizada de acordo com os preceitos estabelecidos pela metodologia Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, na sigla em inglês). Foram selecionados para análise 20 estudos que abordavam o diagnóstico e prevenção de infecções articulares periprotéticas após fraturas de quadril. Observa-se que não há consenso na literatura sobre medidas preventivas para ocorrência de tais processo infecciosos. Dentre os fatores de risco para ocorrência e gravidade das infecções por S. aureus após artroplastias de quadril foram citados obesidade, maior tempo cirúrgico, maior idade, quadros de imunossupressão, uso recente de antibióticos e multicomorbidades. O uso de biomarcadores para diagnóstico precoce, bem como processos de triagem, descolonização e antibioticoprofilaxia estão entre os procedimentos preventivos propostos na literatura.

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Biomaterial-Related Surgical Site Infection: Anti-infectious Metal Coating on Biomaterials

Koseki

Kajiyama

2021

Kenzan Method for Scaffold-Free Biofabrication

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Surgical site infections following hip and knee arthroplastic surgery: Trends and risk factors of Staphylococcus aureus infections

Cited by 6 publications

References 10 publications

Staphylococcus aureus screening and preoperative decolonisation with Mupirocin and Chlorhexidine to reduce the risk of surgical site infections in orthopaedic surgery: a pre-post study

Staphylococcus aureus screening and preoperative decolonisation with Mupirocin and Chlorhexidine to reduce the risk of surgical site infections in orthopaedic surgery: a pre-post study

Diagnóstico e prevenção de infecções articulares periprotéticas por Staphylococcus aureus após fratura de quadril: Revisão sistemática de literatura

Biomaterial-Related Surgical Site Infection: Anti-infectious Metal Coating on Biomaterials

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