International Orthopaedics

, Volume 28, Issue 1, pp 16–20

Strategy to control methicillin-resistant Staphylococcus aureus post-operative infection in orthopaedic surgery

  • J. C. De Lucas-Villarrubia
  • M. Lopez-Franco
  • J. J. Granizo
  • J. C. De Lucas-Garcia
  • E. Gomez-Barrena
Original Paper

Abstract

In the year 2000 the rate of infection after arthroplasty in our hospital was 9.75% and methicillin-resistant Staphylococcus aureus (MRSA) was the organism in 33% of the infected joints. In an attempt to overcome this unacceptable situation, we changed our prophylaxis regime over a period of 6 months. This involved modifying the precautionary measures for preventing surgical infections, active prophylaxis against any nasal reservoir of infection in joint implant patients, the control of health care personnel, the strict application of standard and contact precautions in all patients with MRSA, and the use of teicoplanin as prophylaxis during this 6-month period. This resulted in a definite decrease in the incidence of orthopaedic wound infections by MRSA, while the level of MRSA infection elsewhere in the hospital remained constant. Only one infection was detected during this 6-month trial, and this beneficial effect was maintained during the following 6 months. Since then, only sporadic new infections have been detected. Patients with arthroplasties performed during the study were followed for 12 months, and no new cases of MRSA infection were detected.

Résumé

Dans l'année 2000 le taux d'infection après arthroplastie dans notre Hôpital fût de 9.75% et le Staphylocoque aureus methicilline—résistant (MRSA) était le germe en cause dans 33% des articulations infectées. Dans le but d'améliorer cette situation inacceptable nous avons changé notre méthode de prophylaxie pendant une période de 6 mois. Cela a impliqué de modifier les mesures pour prévenir les infections chirurgicales : prophylaxie active contre tout réservoir nasal d'infection chez les malades devant avoir un implant; contrôle du personnel de soins; stricte application des règles et des précautions de contact chez tous les malades porteurs de MRSA; usage de teicoplanine comme prophylaxie pendant cette période de 6 mois. Le résultat a été une baisse catégorique de la fréquence des infections opératoires orthopédiques par MRSA, tandis que le niveau d'infection MRSA est resté constant ailleurs dans l'hôpital. Une seule infection a été détectée pendant cet essai de 6 mois, et cet effet salutaire a été maintenu pendant les 6 mois suivants. Depuis lors, seules de nouvelles infections sporadiques ont été détectées. Les malades opérés d'arthroplastie pendant l'étude ont été suivis pendant 12 mois et aucun nouveau cas d'infection MRSA n'a été détecté.

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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • J. C. De Lucas-Villarrubia
    • 1
  • M. Lopez-Franco
    • 1
  • J. J. Granizo
    • 2
  • J. C. De Lucas-Garcia
    • 1
  • E. Gomez-Barrena
    • 1
  1. 1.Department of Orthopaedic Surgery, Fundacion Jimenez DiazUniversidad Autonoma de MadridMadridSpain
  2. 2.Epidemiology Unit, Fundacion Jimenez DiazUniversidad Autonoma de MadridMadridSpain

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