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Acta Orthop. 2009 August 7; 80(4): 486–490.
Published online 2009 August 1. doi:  10.3109/17453670903110675
PMCID: PMC2823191
Copyright : © Nordic Orthopedic Federation
Positive nasal culture of methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for surgical site infection in orthopedics
Koichi Yano,corresponding author1 Yukihide Minoda,1 Akira Sakawa,1 Yoshihiro Kuwano,1 Kyoko Kondo,2 Wakaba Fukushima,2 and Koichi Tada1
1Department of Orthopaedic Surgery, Kansai Rosai Hospital, Hyogo, Japan
2Department of Public Health, Osaka City University Graduate School of Medicine, Osaka, Japan
corresponding authorCorresponding author.
Correspondence KY: koichiyano/at/hotmail.com
Received September 25, 2008; Accepted February 27, 2009.
This is an open-access article distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the source is credited.
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Abstract
Background Although nasal carriage of MRSA has been identified as one of the risk factors for surgical site infection (SSI) with MRSA, there have been no reports of this in the orthopedics field.
Methods This prospective observational cohort study included 2,423 consecutive patients who were admitted to our department over 26 months and who underwent orthopedic surgery. We examined the relationship between pre-existing nasal MRSA and subsequent occurrence of SSI with MRSA.
Results 63 patients (2.6%) had a positive nasal MRSA culture. 15 patients (0.6%) developed SSI with MRSA. The occurrence of SSI with MRSA in nasal MRSA carriers was significantly higher than that in non-carriers (4 out of 63 (6.3%) vs. 11 out of 2,360 (0.5%); p < 0.001) (adjusted OR: 11; 95% CI: 3–37; p = 0.001).
Interpretation We recommend appropriate treatment of patients who are nasal carriers of MRSA before orthopedic surgery.
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