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Staphylococcus aureus Colonization in Patients Undergoing Total Hip or Knee Arthroplasty and Cost-effectiveness of

Hosseinali Hadi1,2,3,4,5, Mahmmud Jabalameli1,2,3,4,5, Abolfazl Bagherifard1,2,3,4,5

  • 1Research performed at Bone and Joint Reconstruction Center, Vali-Asr Hospital, Arak University of Medical Sciences, Arak, Iran.

The Archives of Bone and Joint Surgery
|January 15, 2019
PubMed
Abstract

Insights

This study found Staphylococcus aureus colonization in 20.8% of patients before joint replacement surgery. A decolonization program significantly reduces infection risks and costs, proving highly cost-effective for preventing periprosthetic joint infection.

Area of Science:

  • Orthopedic Surgery
  • Infectious Diseases
  • Health Economics

Background:

  • Periprosthetic joint infection (PJI) is a severe complication following total joint arthroplasty (TJA).
  • Staphylococcus aureus colonization, particularly methicillin-resistant strains (MRSA), is a significant risk factor for PJI.
  • Identifying colonization prevalence is crucial for targeted prevention strategies.

Purpose of the Study:

  • To determine the prevalence of Staphylococcus aureus colonization in patients undergoing arthroplasty in central Iran.
  • To evaluate the cost-effectiveness of a decolonization program for preventing post-arthroplasty infections.

Main Methods:

  • A prospective cross-sectional study involving 226 patients scheduled for TJA.
  • Bacteriologic cultures were performed on samples from nose, throat, groin skin, and urine.
  • Cost-effectiveness analysis was conducted for a proposed decolonization program.

Main Results:

  • Overall Staphylococcus aureus colonization rate was 20.8%, with 1.8% being MRSA.
  • Specific colonization sites included nose (15.9%), throat (4.4%), groin skin (3.1%), and urine (0.9%).
  • The decolonization program demonstrated an 80% reduction in associated costs.

Conclusions:

  • While methicillin-sensitive Staphylococcus aureus colonization was lower than reported elsewhere, MRSA rates were comparable.
  • A decolonization program for Staphylococcus aureus is highly cost-effective in patients undergoing hip or knee arthroplasty.
  • Implementing decolonization protocols can mitigate PJI risk and reduce healthcare expenditures.
Keywords:
DecolonizationPeriprosthetic joint infectionStaphylococcus aureusTotal hip arthroplastyTotal knee arthroplasty

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