title: Preoperative Staphylococcus aureus Screening/Decolonization Protocol Before Total Joint Arthroplasty-Results of a Small Prospective Randomized Trial.
abstract: To study the prevalence of Staphylococcus aureus carriage and the impact of preoperatively treating carriers in prosthetic joint infection (PJI), a prospective randomized trial was organized. From January 2010 to December 2012, 1028 of 1305 total joint arthroplasties performed were screened, and selected carriers underwent preoperative decolonization. We observed a 22.2% (228/1028) S aureus colonization rate and only 0.8% methicillin-resistant S aureus. Prosthetic joint infection rate was higher, albeit not significantly, in S aureus carriers than among noncarriers-3.9% (9/228) vs 2.0% (16/800). Treated and untreated carriers showed no significant differences-3.4% (3/89) vs 4.3% (6/139). Most of the 14 S aureus PJI occurred in noncarriers suggesting a lack of causal relation between nasal and PJI S aureus. No clear benefit in screening/decolonizing carriers before total joint arthroplasty could be demonstrated.
authors.affiliation: Department of Orthopaedics, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Ricardo J G
authors.initials: RJ
authors.lastname: Sousa
authors.affiliation: Department of Orthopaedics, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Pedro M B
authors.initials: PM
authors.lastname: Barreira
authors.affiliation: Department of Orthopaedics, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Pedro T S
authors.initials: PT
authors.lastname: Leite
authors.affiliation: Department of Microbiology, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Ana Claudia M
authors.initials: AC
authors.lastname: Santos
authors.affiliation: Department of Microbiology, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Maria Helena S S
authors.initials: MH
authors.lastname: Ramos
authors.affiliation: Department of Orthopaedics, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: António F
authors.initials: AF
authors.lastname: Oliveira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001178:Arthroplasty / Q000009:adverse effects; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D016106:Methicillin Resistance; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000517:prevention & control*; D013211:Staphylococcus aureus; D013530:Surgical Wound Infection / Q000517:prevention & control*; D055815:Young Adult
keywords: Staphylococcus aureus; carrier state; prospective studies; prosthesis-related infections; risk factors; surgical site infection