title: Micro-organism colonization and intraoperative contamination in patients undergoing arthroscopic anterior cruciate ligament reconstruction.
abstract: OBJECTIVE
  To investigate the status of preoperative micro-organism colonization and intraoperative contamination in patients undergoing anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  Fifty patients who underwent scheduled ACL reconstruction were included in the study. At the preoperative checkup, swabs were taken from the skin at the surgical site and the nose. During surgery, swab samples were taken from the skin adjacent to the incision and the surface of the graft and examined for contamination.
  
  
  RESULTS
  Preoperative examination for micro-organism colonization showed positive results in 23 of 50 samples (46%) taken from the skin and 45 of 50 samples (90%) taken from the nose. Intraoperative swab samples taken from the skin and the graft showed positive rates of 6% and 2%, respectively, which were significantly lower compared with the preoperative values (P < .05). The most frequently identified organism in both preoperative and postoperative examinations was coagulase-negative Staphylococcus (CNS), representing 93% of the positive results. Among those CNS strains, roughly one-third of the samples were shown to be methicillin resistant. During the study period, surgical-site infection with methicillin-resistant CNS occurred in 1 patient. In this patient the preoperative culture identified methicillin-sensitive CNS, whereas preoperative nasal culture and intraoperative examinations of the skin and the graft were negative.
  
  
  CONCLUSIONS
  Preoperative examination of micro-organism colonization in patients undergoing ACL reconstruction showed positive results in 46% and 90% of the samples taken from the skin and the nose, respectively. In the intraoperative examination, 6% and 2% of the swabs taken from the adjacent skin and the graft, respectively, showed positive results.
  
  
  METHODS
  Level IV, therapeutic case series.
authors.affiliation: Department of Orthopaedic Surgery, Hyogo College of Medicine, Nishinomiya, Japan. hiroshi0273@mac.com
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Yagi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshiya
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takesue
mesh_terms: D000293:Adolescent; D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D001182:Arthroscopy; D001407:Bacillus / Q000302:isolation & purification; D002437:Cefazolin / Q000627:therapeutic use; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D008875:Middle Aged; D009666:Nose / Q000382:microbiology*; D057234:Preoperative Period; D012867:Skin / Q000382:microbiology*; D013210:Staphylococcus / Q000302:isolation & purification; D013530:Surgical Wound Infection / Q000382:microbiology* / Q000517:prevention & control; D013710:Tendons / Q000382:microbiology* / Q000637:transplantation; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin