Orthopedic surgical site infections: analysis of causative bacteria and implications for antibiotic stewardship.
Data that can be used to guide perioperative antibiotic prophylaxis in our era of emerging antibiotic resistance are limited. We reviewed orthopedic surgeries complicated by surgical site infections (SSIs). Eighty percent of 69 arthroplasty and 80 spine fusion SSIs were infected with Gram-positive bacteria; most were staphylococcal species; and more than 25% of Staphylococcus aureus and more than 65% of coagulase-negative staphylococci were methicillin-resistant. Gram-negative bacteria were isolated from 30% of arthroplasty SSIs and 25% of spine fusion SSIs. Resistance to cefazolin was higher than 40%. A significant proportion of SSIs were caused by resistant organisms, and antibiotic guidelines were altered to provide more adequate surgical prophylaxis.
Thomas D
TD
Norton
Faith
F
Skeete
Yanina
Y
Dubrovskaya
Michael S
MS
Phillips
Department of Orthopaedic Surgery, New York University School of Medicine, New York, NY. joseph.bosco@nyumc.org.
Joseph D
JD
Bosco
Sapna A
SA
Mehta
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D019643:Arthroplasty, Replacement / Q000009:adverse effects*; D006801:Humans; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology*
D000900:Anti-Bacterial Agents