Risk factors for preoperative nasal carriage of methicillin-resistant bacteria in total hip and knee arthroplasty patients.
J Orthop Sci
; 27(4): 798-803, 2022 Jul.
Article
en En
| MEDLINE
| ID: mdl-34090777
ABSTRACT
BACKGROUND:
The present study aimed to identify risk factors for preoperative nasal carriage of resistant bacteria - MRSA methicillin-resistant Staphylococcus (S.) aureus, MRSE (methicillin-resistant Staphylococcus epidermidis), and MRCNS (methicillin-resistant coagulase negative staphylococci) in total hip and knee arthroplasty (THA and TKA) patients.METHODS:
Nasal cultures were obtained from 538 patients before THA (262 primary and 26 revision) and TKA (241 primary and 9 revision). These were classified either as methicillin-resistant bacteria (group MR) or methicillin-susceptible bacteria (including culture-negative) (group MS). Patient characteristics were compared between these groups using logistic regression models.RESULTS:
The resistant bacteria were preoperatively present in 33.1% (178 patients) among all patients. MRSE, MRCNS, and MRSA were detected in 27.5% (148 patients), 3.7% (20 patients), and 1.9% (10 patients). In the unadjusted comparisons of the patient characteristics between the groups MR and MS, a significant difference was found in the percentages of diabetic patients (15.2% vs. 9.2%, P = 0.04); the association remained after the multivariable adjustment for possible risk factors (P < 0.001). In addition, the diabetic patients in the group MR showed a higher percentage of receiving insulin injection than those in the group MS (25.9% vs. 6.1%, P = 0.063), and their mean levels of HbA1c were significantly higher in the group MR than the MS (6.8% vs. 6.4%, P = 0.03).CONCLUSIONS:
We identified diabetes as a risk factor for the preoperative nasal carriage of resistant bacteria. Our results suggest that, in order to prevent a surgical site infection (SSI), extra care should be taken in performing joint arthroplasties for diabetic patients, especially using insulin and with high HbA1c levels (≥6.6%) prior to the surgical procedures.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Infecciones Estafilocócicas
/
Artroplastia de Reemplazo de Cadera
/
Artroplastia de Reemplazo de Rodilla
/
Staphylococcus aureus Resistente a Meticilina
/
Insulinas
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2022
Tipo del documento:
Article