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Staphylococcus aureus screening and decolonization in orthopaedic surgery and reduction of surgical site infections

Antonia F Chen1, Charles B Wessel, Nalini Rao

  • 1Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15206, USA.

Clinical Orthopaedics and Related Research
|March 7, 2013
PubMed
Abstract

Insights

Screening for Staphylococcus aureus and decolonizing patients before orthopedic surgery effectively reduces surgical site infections (SSIs). This protocol is also a cost-effective strategy for preventing SSIs in orthopedic procedures.

Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Control
  • Health Economics

Background:

  • Staphylococcus aureus is a primary cause of orthopedic surgical site infections (SSIs).
  • Patient carriage of S. aureus, including methicillin-resistant strains (MRSA), increases the risk of invasive infections.
  • The efficacy of S. aureus screening and decolonization in reducing SSIs remains under investigation.

Purpose of the Study:

  • To determine if S. aureus screening and decolonization reduce SSIs in orthopedic patients.
  • To assess the cost-effectiveness of implementing S. aureus screening and decolonization protocols.

Main Methods:

  • A systematic review of studies was conducted using major databases (PubMed, EMBASE, Cochrane Library).
  • Literature searches focused on decolonization, MRSA, and orthopedic surgery, with studies published before 1968 excluded.
  • Analysis included 19 studies on SSI reduction and 10 studies on cost-effectiveness.

Main Results:

  • All 19 reviewed studies demonstrated a reduction in SSIs or wound complications with S. aureus screening and decolonization protocols.
  • The protocol proved effective across various elective orthopedic procedures (total joints, spine, sports) and trauma cases.
  • Implementing S. aureus screening and decolonization was found to be cost-effective, considering the reduction in SSIs.

Conclusions:

  • Preoperative screening and decolonization of S. aureus in orthopedic patients is a proven method to reduce SSIs.
  • The protocol represents a cost-effective approach for preventing surgical site infections in orthopedic surgery.

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