MRSA colonisation and subsequent risk of infection despite effective eradication in orthopaedic elective surgery

E Murphy, S J Spencer, D Young, B Jones, M J G Blyth

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

The objective of this study was to determine the effectiveness of screening and successful treatment of methicillin-resistant Staphylococcus aureus (MRSA) colonisation in elective orthopaedic patients on the subsequent risk of developing a surgical site infection (SSI) with MRSA. We screened 5933 elective orthopaedic in-patients for MRSA at pre-operative assessment. Of these, 108 (1.8%) were colonised with MRSA and 90 subsequently underwent surgery. Despite effective eradication therapy, six of these (6.7%) had an SSI within one year of surgery. Among these infections, deep sepsis occurred in four cases (4.4%) and superficial infection in two (2.2%). The responsible organism in four of the six cases was MRSA. Further analysis showed that patients undergoing surgery for joint replacement of the lower limb were at significantly increased risk of an SSI if previously colonised with MRSA. We conclude that previously MRSA-colonised patients undergoing elective surgery are at an increased risk of an SSI compared with other elective patients, and that this risk is significant for those undergoing joint replacement of the lower limb. Furthermore, when an infection occurs, it is likely to be due to MRSA.
LanguageEnglish
Pages548-51
Number of pages4
JournalJournal of Bone and Joint Surgery, British Volume
Volume93
Issue number4
DOIs
Publication statusPublished - Apr 2011

Fingerprint

Methicillin-Resistant Staphylococcus aureus
Orthopedics
Surgical Wound Infection
Infection
Replacement Arthroplasties
Lower Extremity
Sepsis
Therapeutics

Keywords

  • resistant staphylococcus-aureus
  • unit
  • vancomycin
  • prevalence
  • prophylaxis

Cite this

@article{fd5421dc02ac4499b2014895c589e018,
title = "MRSA colonisation and subsequent risk of infection despite effective eradication in orthopaedic elective surgery",
abstract = "The objective of this study was to determine the effectiveness of screening and successful treatment of methicillin-resistant Staphylococcus aureus (MRSA) colonisation in elective orthopaedic patients on the subsequent risk of developing a surgical site infection (SSI) with MRSA. We screened 5933 elective orthopaedic in-patients for MRSA at pre-operative assessment. Of these, 108 (1.8{\%}) were colonised with MRSA and 90 subsequently underwent surgery. Despite effective eradication therapy, six of these (6.7{\%}) had an SSI within one year of surgery. Among these infections, deep sepsis occurred in four cases (4.4{\%}) and superficial infection in two (2.2{\%}). The responsible organism in four of the six cases was MRSA. Further analysis showed that patients undergoing surgery for joint replacement of the lower limb were at significantly increased risk of an SSI if previously colonised with MRSA. We conclude that previously MRSA-colonised patients undergoing elective surgery are at an increased risk of an SSI compared with other elective patients, and that this risk is significant for those undergoing joint replacement of the lower limb. Furthermore, when an infection occurs, it is likely to be due to MRSA.",
keywords = "resistant staphylococcus-aureus, unit, vancomycin, prevalence, prophylaxis",
author = "E Murphy and Spencer, {S J} and D Young and B Jones and Blyth, {M J G}",
year = "2011",
month = "4",
doi = "10.1302/0301-620X.93B4.24969",
language = "English",
volume = "93",
pages = "548--51",
journal = "Journal of Bone and Joint Surgery, British Volume",
issn = "0301-620X",
number = "4",

}

MRSA colonisation and subsequent risk of infection despite effective eradication in orthopaedic elective surgery. / Murphy, E; Spencer, S J; Young, D; Jones, B; Blyth, M J G.

In: Journal of Bone and Joint Surgery, British Volume , Vol. 93, No. 4, 04.2011, p. 548-51.

Research output: Contribution to journalArticle

TY - JOUR

T1 - MRSA colonisation and subsequent risk of infection despite effective eradication in orthopaedic elective surgery

AU - Murphy, E

AU - Spencer, S J

AU - Young, D

AU - Jones, B

AU - Blyth, M J G

PY - 2011/4

Y1 - 2011/4

N2 - The objective of this study was to determine the effectiveness of screening and successful treatment of methicillin-resistant Staphylococcus aureus (MRSA) colonisation in elective orthopaedic patients on the subsequent risk of developing a surgical site infection (SSI) with MRSA. We screened 5933 elective orthopaedic in-patients for MRSA at pre-operative assessment. Of these, 108 (1.8%) were colonised with MRSA and 90 subsequently underwent surgery. Despite effective eradication therapy, six of these (6.7%) had an SSI within one year of surgery. Among these infections, deep sepsis occurred in four cases (4.4%) and superficial infection in two (2.2%). The responsible organism in four of the six cases was MRSA. Further analysis showed that patients undergoing surgery for joint replacement of the lower limb were at significantly increased risk of an SSI if previously colonised with MRSA. We conclude that previously MRSA-colonised patients undergoing elective surgery are at an increased risk of an SSI compared with other elective patients, and that this risk is significant for those undergoing joint replacement of the lower limb. Furthermore, when an infection occurs, it is likely to be due to MRSA.

AB - The objective of this study was to determine the effectiveness of screening and successful treatment of methicillin-resistant Staphylococcus aureus (MRSA) colonisation in elective orthopaedic patients on the subsequent risk of developing a surgical site infection (SSI) with MRSA. We screened 5933 elective orthopaedic in-patients for MRSA at pre-operative assessment. Of these, 108 (1.8%) were colonised with MRSA and 90 subsequently underwent surgery. Despite effective eradication therapy, six of these (6.7%) had an SSI within one year of surgery. Among these infections, deep sepsis occurred in four cases (4.4%) and superficial infection in two (2.2%). The responsible organism in four of the six cases was MRSA. Further analysis showed that patients undergoing surgery for joint replacement of the lower limb were at significantly increased risk of an SSI if previously colonised with MRSA. We conclude that previously MRSA-colonised patients undergoing elective surgery are at an increased risk of an SSI compared with other elective patients, and that this risk is significant for those undergoing joint replacement of the lower limb. Furthermore, when an infection occurs, it is likely to be due to MRSA.

KW - resistant staphylococcus-aureus

KW - unit

KW - vancomycin

KW - prevalence

KW - prophylaxis

UR - http://www.scopus.com/inward/record.url?scp=79953815737&partnerID=8YFLogxK

U2 - 10.1302/0301-620X.93B4.24969

DO - 10.1302/0301-620X.93B4.24969

M3 - Article

VL - 93

SP - 548

EP - 551

JO - Journal of Bone and Joint Surgery, British Volume

T2 - Journal of Bone and Joint Surgery, British Volume

JF - Journal of Bone and Joint Surgery, British Volume

SN - 0301-620X

IS - 4

ER -