Abstract

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).Interpretation We recommend appropriate treatment of patients who are nasal carriers of MRSA before orthopedic surgery.

Highlights

  • Nasal carriage of methicillin-resistant Staphylococcus aureus (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

  • 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)

  • We found that the adjusted odds ratios (ORs) of nasal MRSA for SSI with MRSA after orthopedic surgery was 11 after controlling for the effects of potential confounders

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Summary

Methods

We examined the relationship between pre-existing nasal MRSA and subsequent occurrence of SSI with MRSA

Results
Patients and methods
Discussion
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