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Risk Factors for Developing Staphylococcus aureus Nasal Colonization in Spine and Arthroplasty Surgery

Kirk A Campbell, Colleen Cunningham, Saqib Hasan

    Bulletin of the Hospital for Joint Disease (2013)
    |December 3, 2015
    PubMed

    Insights

    Obesity and asthma are key risk factors for MRSA nasal colonization in orthopedic surgery patients. Identifying these factors can help target pre-operative decolonization, potentially reducing surgical site infections.

    Area of Science:

    • Infectious Diseases
    • Orthopedic Surgery
    • Public Health

    Background:

    • Staphylococcus aureus nasal colonization is a known risk factor for surgical site infections (SSIs).
    • Methicillin-resistant Staphylococcus aureus (MRSA) and Methicillin-sensitive Staphylococcus aureus (MSSA) are common pathogens.
    • Orthopedic surgery, including spine and total joint arthroplasty, carries a risk of SSIs.

    Purpose of the Study:

    • To identify risk factors for nasal colonization by MRSA and MSSA in orthopedic surgery patients.
    • To inform targeted pre-operative decolonization strategies.
    • To potentially reduce the incidence of SSIs.

    Main Methods:

    • Retrospective case-control study.
    • Involved 1,708 consecutively enrolled patients undergoing orthopedic surgery (spine and total joint arthroplasty).
    • Multivariate analysis was used to identify significant risk factors.

    Main Results:

    • Obesity was identified as a significant risk factor for MRSA colonization.
    • Asthma was also identified as a significant risk factor for MRSA colonization.
    • No specific risk factors were highlighted for MSSA in this analysis.

    Conclusions:

    • Obesity and asthma are significant predictors of MRSA nasal colonization in patients undergoing orthopedic surgery.
    • Targeting patients with these risk factors for pre-operative decolonization may be an effective strategy.
    • Reducing MRSA colonization could lead to a decrease in MRSA-related surgical site infections.

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