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Novel Diagnostics in Revision Arthroplasty: Implant Sonication and Multiplex Polymerase Chain Reaction
Published on: December 3, 2017
Prevalence and demographic correlates of Methicillin-Resistant Staphylococcus aureus (MRSA) colonization in patients
Anjali Tiwari1, Ravi Goyal1, Gaurav Sharma1
1Department of Orthopedic Surgery, Sir H N Reliance Foundation Hospital, Girgaum, Mumbai 400004, Maharashtra, India.
Background:
Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant concern in orthopedic surgery, particularly in total knee replacement (TKR), where infection can lead to severe complications. In procedures like TKR, where implants act as a foreign body and potential surface for biofilm formation, infections can lead to severe complications, including delayed healing, and implant failure, and often need multiple revision surgeries. Screening for MRSA before surgery has become a standard practice in many hospitals to reduce the risk of infection. This study aims to evaluate the prevalence of MRSA in patients undergoing TKR and analyze demographic characteristics.
Methods:
A retrospective analysis was conducted on patients scheduled for TKR. Demographic data, including age, gender, and other relevant clinical information, were extracted from the patient's medical records. MRSA screening was performed as part of the preoperative protocol, and the results were recorded. Descriptive statistics were used to summarize the data and calculate the prevalence of MRSA.
Results:
A total of 938 patients underwent MRSA screening prior to TKR. The mean age was 67.25 years (median: 68; range: 33-87). The majority of patients were female, accounting for 706 (75.0%), while 232 (25.0%) were male. MRSA test results revealed that 938 (99.3%) patients tested negative, whereas 6 (0.7%) tested positive. Among MRSA-positive patients, all were aged 60 years or older, suggesting a potential correlation between advanced age and MRSA positivity.
Conclusion:
This study found a low MRSA prevalence (0.7%) in TKR patients, with all cases occurring in individuals aged ≥60 years. The findings advocate prioritizing preoperative screening in older patients to optimize resource use in low-prevalence settings and highlight the need to investigate TKR-specific risk factors for tailored infection control strategies.
Insights
Preoperative screening for Methicillin-resistant Staphylococcus aureus (MRSA) in total knee replacement (TKR) patients revealed a low prevalence of 0.7%. All positive cases were in patients aged 60 and older, suggesting targeted screening for this demographic.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Epidemiology
- Medical Microbiology
Background:
- Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant risk in orthopedic surgery, especially total knee replacement (TKR).
- TKR infections can lead to severe complications like delayed healing, implant failure, and the need for revision surgeries.
- Preoperative MRSA screening is a standard practice to mitigate infection risks.
Purpose of the Study:
- To evaluate the prevalence of MRSA in patients undergoing TKR.
- To analyze demographic characteristics associated with MRSA positivity in this patient group.
Main Methods:
- A retrospective analysis of TKR patients was performed.
- Demographic and clinical data were extracted from medical records.
- Preoperative MRSA screening results were analyzed using descriptive statistics.
Main Results:
- 938 patients were screened pre-TKR; 0.7% tested positive for MRSA.
- The mean age of patients was 67.25 years, with 75% being female.
- All MRSA-positive patients were aged 60 years or older.
Conclusions:
- A low prevalence of MRSA (0.7%) was observed in TKR patients.
- Advanced age (≥60 years) was associated with MRSA positivity.
- Prioritizing screening for older patients may optimize resource allocation in low-prevalence settings.
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