Skip to main content
SpringerLink
Log in

The role of MRSA screening in joint-replacement surgery

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

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.

Résumé

Le but de cette étude prospective était de déterminer l’effet du dépistage du Staphylocoque Aureus Méthicilline Résistant (MRSA) chez des patients devant subir une prothèse de hanche ou de genou, sur la réduction des infections nosocomiales et la durée du séjour hospitalier. Nous avons inclus 395 malades admis pour remplacement prothétique de la hanche et du genou (genou 210 / Hanche 185) du 16 octobre 2000 au 15 octobre 2001. Le groupe 1 a inclus 164 admissions avant le 16 avril 2001 quand les écouvillonnages MRSA n’étaient pas obligatoires. Le groupe 2 a inclus 231 admissions après le 16 avril 2001 quand l’écouvillonnage axillaire, nasal et inguinal devait être négatif pour le MRSA. Cinq malades du groupe 1 ont eu une infection MRSA postopératoire , comparé à l’absence d’infection dans le groupe 2. La durée moyenne de séjour a diminué de 10.43 jours (±SD 4.2 j) dans le groupe 1 à 9.47 jours (±SD 2.6 j ) dans le groupe 2. Il y avait une réduction significative de la fréquence des infections acquises à l’hôpital grâce au dépistage avant l’admission.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Beaujean DJ, Weersink AJ, Blok HE, Frenay HM, Verhoef J (1999) Determining risk factors for methicillin-resistant Staphylococcus aureus carriage after discharge from hospital. J Hosp Infect 42:213–218

    Article  CAS  PubMed  Google Scholar 

  2. Critelli L, Black PN (1993) Preadmission discharge planning shortens LOS (length of stay) for elective orthopedic surgery. Disch Plann Update 13:18–21

    CAS  Google Scholar 

  3. De Lucas-Villarrubia JC, Lopez-Franco M, Granizo JJ, De Lucas-Garcia JC, Gomez-Barrena E (2004) Strategy to control methicillin-resistant Staphylococcus aureus post-operative infection in orthopaedic surgery. Int Orthop 28:16–20

    Article  PubMed  Google Scholar 

  4. Engemann JJ, Carmeli Y, Cosgrove SE, Fowler VG, Bronstein MZ, Trivette SL, Briggs JP, Sexton DJ, Kaye KS (2003) Adverse clinical and economic outcomes attributable to methicillin resistance among patients with Staphylococcus aureus surgical site infection. Clin Infect Dis 36:592–598

    Article  PubMed  Google Scholar 

  5. Fruhauf G, Heuck D, Tomaschewski R, Witte W, Langer S, Bretschneider M (1996) 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 134:273–282

    CAS  PubMed  Google Scholar 

  6. Garrouste-Orgeas M, Timsit JF, Kallel H, Ben Ali A, Dumay MF, Paoli B, Misset B, Carlet J (2001) Colonization with methicillin-resistant Staphylococcus aureus in ICU patients: morbidity, mortality, and glycopeptide use. Infect Control Hosp Epidemiol 22:687–692

    CAS  PubMed  Google Scholar 

  7. Huang SS, Platt R (2003) Risk of methicillin-resistant Staphylococcus aureus infection after previous infection or colonization. Clin Infect Dis 36:281–285

    Article  PubMed  Google Scholar 

  8. James LA, Sookhan N, Subar D (2001) Timing of operative intervention in the management of acutely fractured ankles and the cost implications. Injury 32:469–472

    Article  CAS  PubMed  Google Scholar 

  9. Khan OA, Weston VC, Scammell BE (2002) Methicillin-resistant Staphylococcus aureus incidence and outcome in patients with neck of femur fractures. J Hosp Infect 51:185–188

    Article  CAS  PubMed  Google Scholar 

  10. Kim S, Losina E, Solomon DH, Wright J, Katz JN (2003) Effectiveness of clinical pathways for total knee and total hip arthroplasty: literature review. J Arthroplasty 18:69–74

    Article  PubMed  Google Scholar 

  11. Konig DP, Randerath O, Hackenbroch MH (1999) Nosocomial infections with methicillin-resistant Staphylococcus aureus (MRSA) and epidermidis (MRSE) strains. Their importance, prophylaxis and therapy in orthopedic surgery. Unfallchirurg 102:324–328

    Article  CAS  PubMed  Google Scholar 

  12. Kotilainen P, Routamaa M, Peltonen R, Oksi J, Rintala E, Meurman O, Lehtonen OP, Eerola E, Salmenlinna S, Vuopio-Varkila J, Rossi T (2003) Elimination of epidemic methicillin-resistant Staphylococcus aureus from a university hospital and district institutions, Finland. Emerg Infect Dis 9:169–175

    PubMed  Google Scholar 

  13. Liebergall M, Soskolne V, Mattan Y, Feder N, Segal D, Spira S, Schneidman G, Stern Z, Israeli A (1999) Preadmission screening of patients scheduled for hip and knee replacement: impact on length of stay. Clin Perform Qual Health Care 7:17–22

    CAS  PubMed  Google Scholar 

  14. Said-Salim B, Mathema B, Kreiswirth BN (2003) Community-acquired methicillin-resistant Staphylococcus aureus: an emerging pathogen. Infect Control Hosp Epidemiol 24:451–455

    PubMed  Google Scholar 

  15. Samad A, Banerjee D, Carbarns N, Ghosh S (2002) Prevalence of methicillin-resistant Staphylococcus aureus colonization in surgical patients, on admission to a Welsh hospital. J Hosp Infect 51:43–46

    Article  CAS  PubMed  Google Scholar 

  16. Tai CC, Nirvani AA, Holmes A, Hughes SP (2004) Methicillin-resistant Staphylococcus aureus in orthopaedic surgery. Int Orthop 28:32–35

    Article  CAS  PubMed  Google Scholar 

  17. Talon D, Vichard P, Muller A, Bertin M, Jeunet L, Bertrand X (2003) Modelling the usefulness of a dedicated cohort facility to prevent the dissemination of MRSA. J Hosp Infect 54:57–62

    Article  CAS  PubMed  Google Scholar 

  18. Wilcox MH, Hall J, Pike H, Templeton PA, Fawley WN, Parnell P, Verity P (2003) Use of perioperative mupirocin to prevent methicillin-resistant Staphylococcus aureus (MRSA) orthopaedic surgical site infections. J Hosp Infect 54:196–201

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Alexandra Hospital, Redditch, Worcestershire, B98 7UB, UK

    B. Sankar & K. M. Bell

  2. 36 Arley House, 1 Amberley Drive, Manchester, M23 2RP, UK

    B. Sankar

  3. Royal Bolton Hospital, Minerva Road, Farnworth, Bolton, BL4 0JR, UK

    P. Hopgood

Authors
  1. B. Sankar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Hopgood
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. M. Bell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to B. Sankar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sankar, B., Hopgood, P. & Bell, K.M. The role of MRSA screening in joint-replacement surgery. International Orthopaedics (SICOT) 29, 160–163 (2005). https://doi.org/10.1007/s00264-005-0649-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-005-0649-3

Keywords

Search

Navigation