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Published on: March 3, 2023

Staphylococcus aureus nasal decolonization in joint replacement surgery reduces infection

Donna M Hacek1, William J Robb, Suzanne M Paule

  • 1Evanston Northwestern Healthcare, Evanston, IL, USA. dhacek@enh.org

Clinical Orthopaedics and Related Research
|March 19, 2008
PubMed
Abstract

Insights

Preoperative screening and decolonization for Staphylococcus aureus nasal carriers significantly reduced surgical site infections (SSIs) in hip and knee replacement patients. This targeted approach offers a promising strategy to enhance patient safety and prevent post-operative complications.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Control
  • Microbiology

Background:

  • Surgical site infections (SSIs) caused by Staphylococcus aureus are a significant risk following hip and knee replacement surgeries.
  • Staphylococcus aureus nasal carriage is a major risk factor for developing SSIs.

Purpose of the Study:

  • To evaluate the effectiveness of a preoperative screening and decolonization program for Staphylococcus aureus nasal carriers in reducing SSIs after hip and knee replacements.

Main Methods:

  • Prospective screening of surgical candidates for S. aureus nasal carriage using real-time PCR.
  • Preoperative decolonization of identified carriers with mupirocin.
  • Comparison of SSI rates in screened and decolonized patients versus control groups.

Main Results:

  • Of 912 screened patients, 223 (24.5%) were S. aureus carriers and decolonized. Only 1.3% of these patients developed SSIs.
  • Screen-negative patients had a 0.6% SSI rate.
  • Control patients (unscreened/undecolonized) had a 1.7% rate of S. aureus SSIs.

Conclusions:

  • Preoperative screening for S. aureus nasal carriage followed by mupirocin decolonization is effective in reducing the incidence of SSIs after hip and knee replacement surgery.
  • This intervention can significantly improve patient outcomes and reduce healthcare-associated infections.

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