Airborne contamination and postoperative infection after total hip replacement

The results of 163 hip replacements at the Uppsala University Hospital are presented. Deep infection occurred in ten cases and was caused by Staphylococcus aureus in four early or intermediate infections and by anaerobes in four late infections. The remaining two infections (both of which were late) were probably associated with Staphylococcus albus--in one case possibly also with alpha streptococci. Two superficial infections not affecting the operative result were caused by Staphylococcus aureus and betahaemolytic streptococci. The results of environmental analyses of staphylococci and the total number of bacteria in the air during 77 operations did not indicate that airborne infection is a major cause of postoperative infections--there was no difference between the number of bacteria found in the air during operations after which infection occurred and uninfected operations, and the use of special zonal ventilation with high rates of air exchange in the operating area had no effect on the infection frequency.