Positive nasal culture of methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for surgical site infection in orthopedics.
BACKGROUND
Although nasal carriage of MRSA has been identified as one of the risk factors for surgical site infection (SSI) with MRSA, there have been no reports of this in the orthopedics field.


METHODS
This prospective observational cohort study included 2,423 consecutive patients who were admitted to our department over 26 months and who underwent orthopedic surgery. We examined the relationship between pre-existing nasal MRSA and subsequent occurrence of SSI with MRSA.


RESULTS
63 patients (2.6%) had a positive nasal MRSA culture. 15 patients (0.6%) developed SSI with MRSA. The occurrence of SSI with MRSA in nasal MRSA carriers was significantly higher than that in non-carriers (4 out of 63 (6.3%) vs. 11 out of 2,360 (0.5%); p < 0.001) (adjusted OR: 11; 95% CI: 3-37; p = 0.001).


CONCLUSIONS
We recommend appropriate treatment of patients who are nasal carriers of MRSA before orthopedic surgery.
Yano
Koichi
K
Department of Orthopaedic Surgery, Kansai Rosai Hospital, Hyogo, Japan. koichiyano@hotmail.com
Minoda
Yukihide
Y
Sakawa
Akira
A
Kuwano
Yoshihiro
Y
Kondo
Kyoko
K
Fukushima
Wakaba
W
Tada
Koichi
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002353:Carrier State / Q000382:microbiology / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D009296:Nasal Cavity / Q000382:microbiology*; D011446:Prospective Studies; D016459:Prosthesis-Related Infections / Q000382:microbiology* / Q000517:prevention & control; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology*; D013530:Surgical Wound Infection / Q000382:microbiology* / Q000517:prevention & control; D055815:Young Adult