Predictors of Staphylococcus aureus Colonization and Results after Decolonization
Protocols for the screening and decolonization of Staphylococcus aureus prior to total joint arthroplasty (TJA) have become widely adopted. The goals of this study were to determine: (1) whether implementation of a screening protocol followed by decolonization with mupirocin/vancomycin and chlorhexi...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Interdisciplinary Perspectives on Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2016/4367156 |
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| author | Tennison L. Malcolm Le Don Robinson Alison K. Klika Deepak Ramanathan Carlos A. Higuera Trevor G. Murray |
| author_facet | Tennison L. Malcolm Le Don Robinson Alison K. Klika Deepak Ramanathan Carlos A. Higuera Trevor G. Murray |
| author_sort | Tennison L. Malcolm |
| collection | DOAJ |
| description | Protocols for the screening and decolonization of Staphylococcus aureus prior to total joint arthroplasty (TJA) have become widely adopted. The goals of this study were to determine: (1) whether implementation of a screening protocol followed by decolonization with mupirocin/vancomycin and chlorhexidine reduces the risk of revision compared with no screening protocol (i.e., chlorhexidine alone) and (2) whether clinical criteria could reliably predict colonization with MSSA and/or MRSA. Electronic medical records of primary patients undergoing TJA that were screened (n=3,927) and were not screened (n=1,751) for Staphylococcus aureus at least 4 days prior to surgery, respectively, were retrospectively reviewed. All patients received chlorhexidine body wipes preoperatively. Patients carrying MSSA and MRSA were treated preoperatively with mupirocin and vancomycin, respectively, along with the standard preoperative antibiotics and chlorhexidine body wipes. Screened patients were 50% less likely to require revision due to prosthetic joint infection compared to those not screened (p=0.04). Multivariate regression models were poorly accurate in predicting colonization with MSSA (AUC = 0.58) and MRSA (AUC = 0.62). These results support the routine screening and decolonization of S. aureus prior to TJA. |
| format | Article |
| id | doaj-art-0d0790f026d74cf38507786f2793f764 |
| institution | Kabale University |
| issn | 1687-708X 1687-7098 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Interdisciplinary Perspectives on Infectious Diseases |
| spelling | doaj-art-0d0790f026d74cf38507786f2793f7642025-02-03T05:57:57ZengWileyInterdisciplinary Perspectives on Infectious Diseases1687-708X1687-70982016-01-01201610.1155/2016/43671564367156Predictors of Staphylococcus aureus Colonization and Results after DecolonizationTennison L. Malcolm0Le Don Robinson1Alison K. Klika2Deepak Ramanathan3Carlos A. Higuera4Trevor G. Murray5Department of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A41, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A41, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A41, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A41, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A41, Cleveland, OH 44195, USADepartment of Orthopaedic Surgery, Cleveland Clinic, 9500 Euclid Avenue, A41, Cleveland, OH 44195, USAProtocols for the screening and decolonization of Staphylococcus aureus prior to total joint arthroplasty (TJA) have become widely adopted. The goals of this study were to determine: (1) whether implementation of a screening protocol followed by decolonization with mupirocin/vancomycin and chlorhexidine reduces the risk of revision compared with no screening protocol (i.e., chlorhexidine alone) and (2) whether clinical criteria could reliably predict colonization with MSSA and/or MRSA. Electronic medical records of primary patients undergoing TJA that were screened (n=3,927) and were not screened (n=1,751) for Staphylococcus aureus at least 4 days prior to surgery, respectively, were retrospectively reviewed. All patients received chlorhexidine body wipes preoperatively. Patients carrying MSSA and MRSA were treated preoperatively with mupirocin and vancomycin, respectively, along with the standard preoperative antibiotics and chlorhexidine body wipes. Screened patients were 50% less likely to require revision due to prosthetic joint infection compared to those not screened (p=0.04). Multivariate regression models were poorly accurate in predicting colonization with MSSA (AUC = 0.58) and MRSA (AUC = 0.62). These results support the routine screening and decolonization of S. aureus prior to TJA.http://dx.doi.org/10.1155/2016/4367156 |
| spellingShingle | Tennison L. Malcolm Le Don Robinson Alison K. Klika Deepak Ramanathan Carlos A. Higuera Trevor G. Murray Predictors of Staphylococcus aureus Colonization and Results after Decolonization Interdisciplinary Perspectives on Infectious Diseases |
| title | Predictors of Staphylococcus aureus Colonization and Results after Decolonization |
| title_full | Predictors of Staphylococcus aureus Colonization and Results after Decolonization |
| title_fullStr | Predictors of Staphylococcus aureus Colonization and Results after Decolonization |
| title_full_unstemmed | Predictors of Staphylococcus aureus Colonization and Results after Decolonization |
| title_short | Predictors of Staphylococcus aureus Colonization and Results after Decolonization |
| title_sort | predictors of staphylococcus aureus colonization and results after decolonization |
| url | http://dx.doi.org/10.1155/2016/4367156 |
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