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What Is the Prevalence of MRSA Colonization in Elective Spine Cases?

  • Symposium: 2011 Musculoskeletal Infection Society
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

The incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing. However, the prevalence of MRSA colonization among patients undergoing spine surgery is unclear.

Questions/purposes

We therefore (1) determined the prevalence of MRSA colonization in a population of patients scheduled for elective spine surgery; and (2) evaluated whether MRSA screening and treatment reduce the rate of early wound complications.

Methods

We retrospectively reviewed prospectively collected data from 1002 patients undergoing elective spine surgery in 2010. There were 719 primary and 283 revision surgeries. Instrumentation was used in 72.0% cases and autologous iliac crest bone graft was taken in 65.1%. Twelve patients were lost to followup; of the remaining 990 patients, 503 were screened for MRSA and 487 were not. MRSA-colonized patients were treated with mupirocin and chlorhexidine. An early wound complication was defined as wound drainage or the presence of an abscess. Patients were followed for a minimum of 3 months (average, 7 months; range, 3–545 days).

Results

Of the patients undergoing elective spine surgery and screened for MRSA, 14 of 503 (2.8%) were colonized with MRSA. The rates of early wound complications were similar for patients who were screened and pretreated for MRSA (17 of 503 [3.4%]) compared with those who were not (17 of 487 [3.5%]).

Conclusions

The colonization rate for MRSA in our elective spine surgery population was comparable to that in the arthroplasty literature.

Level of Evidence

Level III, retrospective comparative study. See the Guidelines for Authors for a complete description of levels of evidence.

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Acknowledgments

We thank Dr Nalini Rao for her infectious disease expertise and assistance with the MRSA/MSSA screening and decolonization program at our institution.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA

    Antonia F. Chen MD, MBA, Lloydine J. Jacobs MD & Joon Y. Lee MD

  2. University of Pittsburgh Medical School, Pittsburgh, PA, USA

    Srinivas Chivukula BS & Matthew W. Tetreault BA

Authors
  1. Antonia F. Chen MD, MBA
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  2. Srinivas Chivukula BS
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  3. Lloydine J. Jacobs MD
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  4. Matthew W. Tetreault BA
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  5. Joon Y. Lee MD
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Corresponding author

Correspondence to Joon Y. Lee MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Each author certifies that his or her institution approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at the University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

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Chen, A.F., Chivukula, S., Jacobs, L.J. et al. What Is the Prevalence of MRSA Colonization in Elective Spine Cases?. Clin Orthop Relat Res 470, 2684–2689 (2012). https://doi.org/10.1007/s11999-012-2316-5

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  • DOI: https://doi.org/10.1007/s11999-012-2316-5

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