Infection in total joint replacements. Why we screen MRSA when MRSE is the problem?
A retrospective review of MRSA screening showed that of a total of 8911 patients screened pre-operatively between May 1996 and February 2001, 83 (0.9%) had MRSA isolated from one source or another. During the same period, 115 (13.6%) of 844 positive tissue samples taken during surgery grew Staphylococcus aureus. Of these only 1 (0.01%) was reported to be methicillin-resistant (MRSA). However, a total of 366 (43.4%) isolates from tissue samples were reported as coagulase-negative staphylococci (C-NS). Of these, 312 samples were tested for methicillin sensitivity, of which 172 (55.1%) were found to be resistant. Staphylococcus epidermidis is the most prevalent and persistent species found on most skin and mucous membranes, constituting 65% to 90% of all staphylococci. Most isolates in tissue samples were found to be methicillin-resistant coagulase-negative staphylococcus (55.1%). Hence, it may be appropriate to undertake screening for methicillin-resistant Staphylococcus epidermidis in addition to that for MRSA.
Mohanty
S S
SS
Wrightington Hospital for Joint Diseases, Wigan, England, UK.
Kay
P R
PR
D019643:Arthroplasty, Replacement / Q000009:adverse effects* / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016106:Methicillin Resistance; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification*; D013212:Staphylococcus epidermidis / Q000187:drug effects / Q000302:isolation & purification*; D016019:Survival Analysis