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Staphylococcus aureus nasal colonisation: prevalence and risk factors in a cohort of patients undergoing elective
M Gallouche1, B Rubens Duval2, S Boisset3
1University Grenoble Alpes/CNRS, Grenoble INP, MESP TIMC UMR 5525, Grenoble, France; Infection prevention and control unit, Grenoble Alps University Hospital, Grenoble, France.
Background:
The risk factors for Staphylococcus aureus nasal colonisation have been well described, but studies focusing on orthopaedic surgery patients are scarce.
Aim:
The objective was to analyse the risk factors for S. aureus nasal colonisation in patients undergoing elective orthopaedic surgery.
Methods:
A retrospective study was conducted in one orthopaedics department, including adult patients who benefited from a nasal screening from February 8th, 2017 to June 30th, 2021 before elective orthopaedic surgery. The predictive factors were assessed with a logistic regression model.
Findings:
A total of 4354 patients were included. Among them, 29.4% (1282/4354) had a positive screening test, of which 2.1% were positive for meticillin-resistant S. aureus (27/1282). In multivariate analysis, having a history of S. aureus colonisation was significantly and strongly associated with preoperative S. aureus nasal colonisation (adjusted odds ratio: 58.34; 95% confidence interval: 13.21-257.78). Having no history of S. aureus screening (4.17; 1.49-11.69) compared to negative screenings only, age between 50 and 59 years (1.62; 1.10-2.38) or age <50 years (1.87; 1.28-2.74) compared to age ≥80 years, male gender (1.64; 1.41-1.91), and BMI ≥35 kg/m2 (2.03; 1.08-3.79) compared to BMI <18.5 were also risk factors.
Conclusion:
In our cohort, having a history of positive S. aureus nasal screening or no history of nasal screening (compared with a history of negative screenings), male gender, younger age, and high BMI were independent risk factors for preoperative S. aureus nasal colonisation. The relative weight of risk factors highlights the importance of knowing colonisation history to accurately assess the risk.
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