Bacterial contaminants and antibiotic prophylaxis in total hip arthroplasty.
J Bone Joint Surg Br
; 87(9): 1256-8, 2005 Sep.
Article
em En
| MEDLINE
| ID: mdl-16129753
ABSTRACT
We have investigated the contaminating bacteria in primary hip arthroplasty and their sensitivity to the prophylactic antibiotics currently in use. Impressions (627) of the gloved hands of the surgical team in 50 total hip arthroplasties were obtained on blood agar. The gloves were changed after draping, at intervals of 20 minutes thereafter, and before using cement. Changes were also undertaken whenever a visible puncture was detected. The culture plates were incubated at 37 degrees C for 48 hours. Isolates were identified and tested for sensitivity to flucloxacillin, which is a recognised indicator of sensitivity to cefuroxime. They were also tested against other agents depending upon their appearance on Gram staining. We found contamination in 57 (9%) impressions and 106 bacterial isolates. Coagulase-negative staphylococci were seen most frequently (68.9%), but we also isolated Micrococcus (12.3%), diphtheroids (9.4%), Staphylococcus aureus (6.6%) and Escherichia coli (0.9%). Of the coagulase-negative staphylococci, only 52.1% were sensitive to flucloxacillin and therefore to cefuroxime. We believe that it is now appropriate to review the relevance of prophylaxis with cefuroxime and to consider the use of other agents.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecção Hospitalar
/
Infecções Relacionadas à Prótese
/
Antibioticoprofilaxia
/
Artroplastia de Quadril
Limite:
Humans
Idioma:
En
Ano de publicação:
2005
Tipo de documento:
Article