In the JournalsPerspective

Increased risk of SSI seen in MRSA-colonized patients who underwent THA or TKA

Results from a recently published study demonstrated MRSA-colonized patients who underwent total hip arthroplasty or total knee arthroplasty had a significantly increased risk of surgical site infection compared with non-MRSA carriers.

Researchers performed a retrospective analysis of 3,347 patients who underwent THA and 3,266 patients who underwent TKA. Patients preoperatively colonized with MRSA were identified. Investigators compared infection rates been MRSA carriers and non-MRSA carriers.

There was a colonization rate of 1.3%. Investigators noted 79 patients confirmed eradication of carrier status prior to surgical intervention. Of these patients, 38 underwent THA and 41 underwent TKA. Of the 79 patients, five developed a deep surgical site infection within 1 year postoperatively.

In patients who underwent THA, two had MRSA infections. In patients who underwent TKA, there were two MRSA infections and one methicillin-sensitive Staphylococcus aureus infection. According to researchers, the MRSA-negative control group had a significant statistical difference in infection rates, with a 1.7% deep sepsis rate in 1.17% of THAs and 1.3% in TKAs. – by Monica Jaramillo

 

Disclosures: The authors report no relevant financial disclosures.

Results from a recently published study demonstrated MRSA-colonized patients who underwent total hip arthroplasty or total knee arthroplasty had a significantly increased risk of surgical site infection compared with non-MRSA carriers.

Researchers performed a retrospective analysis of 3,347 patients who underwent THA and 3,266 patients who underwent TKA. Patients preoperatively colonized with MRSA were identified. Investigators compared infection rates been MRSA carriers and non-MRSA carriers.

There was a colonization rate of 1.3%. Investigators noted 79 patients confirmed eradication of carrier status prior to surgical intervention. Of these patients, 38 underwent THA and 41 underwent TKA. Of the 79 patients, five developed a deep surgical site infection within 1 year postoperatively.

In patients who underwent THA, two had MRSA infections. In patients who underwent TKA, there were two MRSA infections and one methicillin-sensitive Staphylococcus aureus infection. According to researchers, the MRSA-negative control group had a significant statistical difference in infection rates, with a 1.7% deep sepsis rate in 1.17% of THAs and 1.3% in TKAs. – by Monica Jaramillo

 

Disclosures: The authors report no relevant financial disclosures.

    Perspective
    R. Michael Meneghini

    R. Michael Meneghini

    Tandon and co-authors have reported an interesting study on an important topic regarding the potential for an increased incidence of surgical site infection (SSI) in patients undergoing primary hip and knee arthroplasty who were MRSA colonized preoperatively. The authors report a statistically significant increase in the rate of deep SSI in patients, with a relative risk of approximately five times those not colonized with MRSA preoperatively. 

        While the results may be intuitive, the study does not provide sufficient details on the methodology to support the author conclusions. For example, perioperative infection prevention protocols are not elucidated.  The authors do not detail the time standard antibiotic “prophylaxis” was utilized nor do they detail how they treated the wounds, such as with an occlusive dressing, which can affect infection rates. In addition, the authors do not investigate any demographic characteristics or infection risk factors for the non-MRSA group. Finally, they do not describe if any temporal relationship occur as the study takes place over 5 years, during which time many changes that affect deep SSI rates are likely to occur. Unfortunately, despite the importance of the topic, the scientific methodology does not support the conclusions.

    • R. Michael Meneghini, MD
    • Director of joint replacement at IU Health Saxony Hospital Associate professor of orthopedic surgery Indiana University School of Medicine Indianapolis

    Disclosures: Meneghini reports no relevant financial disclosures.