PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of intorthopspringer.comThis journalToc AlertsOpen ChoiceSubmit Online
 
Int Orthop. 2005 June; 29(3): 160–163.
Published online 2005 April 30. doi:  10.1007/s00264-005-0649-3
PMCID: PMC3456888

The role of MRSA screening in joint-replacement surgery

Abstract

The aim of this prospective study was to determine the effect of screening for methicillin-resistant Staphylococcus aureus (MRSA), in patients undergoing total hip and knee replacements, on reducing hospital-acquired infections and the length of hospital stay. We included 395 patients admitted to the elective orthopaedic ward for hip and knee replacements (knee 210; hip 185) from 16 October 2000 to 15 October 2001. Group 1 included 164 admissions before 16 April 2001 when MRSA swabs were not compulsory. Group 2 included 231 admissions after 16 April 2001 when axillary, nasal and groin swabs had to be negative for MRSA. Four patients in group 1 had post-operative MRSA infection compared with none in group 2. The mean length of hospital stay decreased significantly from 10.43 days ± SD 4.2 days in group 1 to 9.47 days ± SD 2.6 days in group 2. There was a significant reduction in the incidence of hospital-acquired infections following the introduction of pre-admission screening.

Full Text

The Full Text of this article is available as a PDF (79K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
1. Beaujean DJ, Weersink AJ, Blok HE, Frenay HM, Verhoef J. Determining risk factors for methicillin-resistant Staphylococcus aureus carriage after discharge from hospital. J Hosp Infect. 1999;42:213–218. doi: 10.1053/jhin.1999.0585. [PubMed] [Cross Ref]
2. Critelli L, Black PN. Preadmission discharge planning shortens LOS (length of stay) for elective orthopedic surgery. Disch Plann Update. 1993;13:18–21. [PubMed]
3. Lucas-Villarrubia JC, Lopez-Franco M, Granizo JJ, Lucas-Garcia JC, Gomez-Barrena E. Strategy to control methicillin-resistant Staphylococcus aureus post-operative infection in orthopaedic surgery. Int Orthop. 2004;28:16–20. doi: 10.1007/s00264-003-0460-y. [PMC free article] [PubMed] [Cross Ref]
4. Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL, Briggs JP, Sexton DJ, Kaye KS. Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis. 2003;36:592–598. doi: 10.1086/367653. [PubMed] [Cross Ref]
5. Fruhauf G, Heuck D, Tomaschewski R, Witte W, Langer S, Bretschneider M. Outbreak of infection with methicillin-resistant Staphylococcus aureus (MRSA) in an orthopedic septic care unit-measures for eradication and subsequent colonization studies. Z Orthop Ihre Grenzgeb. 1996;134:273–282. [PubMed]
6. Garrouste-Orgeas M, Timsit JF, Kallel H, Ben Ali A, Dumay MF, Paoli B, Misset B, Carlet J. Colonization with methicillin-resistant Staphylococcus aureus in ICU patients: morbidity, mortality, and glycopeptide use. Infect Control Hosp Epidemiol. 2001;22:687–692. [PubMed]
7. Huang SS, Platt R. Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clin Infect Dis. 2003;36:281–285. doi: 10.1086/345955. [PubMed] [Cross Ref]
8. James LA, Sookhan N, Subar D. Timing of operative intervention in the management of acutely fractured ankles and the cost implications. Injury. 2001;32:469–472. doi: 10.1016/S0020-1383(00)00254-0. [PubMed] [Cross Ref]
9. Khan OA, Weston VC, Scammell BE. Methicillin-resistant Staphylococcus aureus incidence and outcome in patients with neck of femur fractures. J Hosp Infect. 2002;51:185–188. doi: 10.1053/jhin.2002.1257. [PubMed] [Cross Ref]
10. Kim S, Losina E, Solomon DH, Wright J, Katz JN. Effectiveness of clinical pathways for total knee and total hip arthroplasty: literature review. J Arthroplasty. 2003;18:69–74. doi: 10.1054/arth.2003.50030. [PubMed] [Cross Ref]
11. Konig DP, Randerath O, Hackenbroch MH. Nosocomial infections with methicillin-resistant Staphylococcus aureus (MRSA) and epidermidis (MRSE) strains. Their importance, prophylaxis and therapy in orthopedic surgery. Unfallchirurg. 1999;102:324–328. doi: 10.1007/s001130050410. [PubMed] [Cross Ref]
12. Kotilainen P, Routamaa M, Peltonen R, Oksi J, Rintala E, Meurman O, Lehtonen OP, Eerola E, Salmenlinna S, Vuopio-Varkila J, Rossi T. Elimination of epidemic methicillin-resistant Staphylococcus aureus from a university hospital and district institutions, Finland. Emerg Infect Dis. 2003;9:169–175. [PMC free article] [PubMed]
13. Liebergall M, Soskolne V, Mattan Y, Feder N, Segal D, Spira S, Schneidman G, Stern Z, Israeli A. Preadmission screening of patients scheduled for hip and knee replacement: impact on length of stay. Clin Perform Qual Health Care. 1999;7:17–22. [PubMed]
14. Said-Salim B, Mathema B, Kreiswirth BN. Community-acquired methicillin-resistant Staphylococcus aureus: an emerging pathogen. Infect Control Hosp Epidemiol. 2003;24:451–455. [PubMed]
15. Samad A, Banerjee D, Carbarns N, Ghosh S. Prevalence of methicillin-resistant Staphylococcus aureus colonization in surgical patients, on admission to a Welsh hospital. J Hosp Infect. 2002;51:43–46. doi: 10.1053/jhin.2002.1182. [PubMed] [Cross Ref]
16. Tai CC, Nirvani AA, Holmes A, Hughes SP. Methicillin-resistant Staphylococcus aureus in orthopaedic surgery. Int Orthop. 2004;28:32–35. doi: 10.1007/s00264-003-0505-2. [PMC free article] [PubMed] [Cross Ref]
17. Talon D, Vichard P, Muller A, Bertin M, Jeunet L, Bertrand X. Modelling the usefulness of a dedicated cohort facility to prevent the dissemination of MRSA. J Hosp Infect. 2003;54:57–62. doi: 10.1016/S0195-6701(03)00086-0. [PubMed] [Cross Ref]
18. Wilcox MH, Hall J, Pike H, Templeton PA, Fawley WN, Parnell P, Verity P. Use of perioperative mupirocin to prevent methicillin-resistant Staphylococcus aureus (MRSA) orthopaedic surgical site infections. J Hosp Infect. 2003;54:196–201. doi: 10.1016/S0195-6701(03)00147-6. [PubMed] [Cross Ref]

Articles from International Orthopaedics are provided here courtesy of Springer-Verlag