A bundle that includes active surveillance, contact precaution for carriers, and cefazolin-based antimicrobial prophylaxis prevents methicillin-resistant Staphylococcus aureus infections in clean orthopedic surgery - 23/01/16
, Kazuaki Matsumoto, PhD a, Akari Shigemi, MSc a, Michiyo Orita, MSc a, c, Aya Nakagawa, RN a, c, Satoko Nozima, RN c, Hiroyuki Tominaga, MD, PhD b, Takao Setoguchi, MD, PhD d, Setsuro Komiya, MD, PhD b, Koichi Tokuda, MD, PhD, MPH a, Junichiro Nishi, MD, PhD aAbstract |
Background |
Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of orthopedic surgical site infections (SSIs). The aim of this study was to evaluate the effect of a bundle approach in the prevention of orthopedic MRSA SSIs.
Material and Methods |
MRSA active surveillance and decolonization were performed preoperatively at our institution from July 2004 until 2007. In January 2008, a bundle approach comprising contact precautions for MRSA-positive patients and cefazolin-based antimicrobial prophylaxis (AMP) stewardship was implemented. Data on the prevalence of MRSA SSIs, antimicrobial use density, duration of AMP, and the use of an alcohol antiseptic agent (L/1,000 patient-days) were evaluated during 2 periods: July 2004-December 2007 (period A) and January 2008-December 2012 (period B).
Results and Discussion |
The MRSA SSI rate during period B (0.97%; 19 out of 1,966) was significantly lower than that during period A (2.17%; 29 out of 1,333; P = .003). The infection rate correlated negatively with both the cefazolin antimicrobial use density (r = −0.76; P = .0002) and the use of an alcohol antiseptic agent (r = −0.68; P = .002).
Conclusions |
An infection-prevention bundle consisting of contact precautions for carriers and AMP stewardship in addition to active surveillance was associated with a significant decrease in the incidence of orthopedic MRSA SSIs.
Le texte complet de cet article est disponible en PDF.Highlights |
• | We implemented a prevention bundle for orthopedic MRSA SSIs. |
• | The bundle reinforced contact precaution and AMP stewardship. |
• | The MRSA SSI rate correlated negatively with cefazolin AUD. |
• | Prolonged AMP may increase the risk of MRSA SSI. |
• | The bundle was associated with the decrease in the incidence of MRSA SSI. |
Key Words : Orthopedic surgical site infection, MRSA, Nasal screening, Transmission
Plan
| This work was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI grant No. 25870567. |
|
| Conflicts of interest: None to report. |
Vol 44 - N° 2
P. 210-214 - février 2016 Retour au numéro
Article précédent
- Copper surfaces are associated with significantly lower concentrations of bacteria on selected surfaces within a pediatric intensive care unit
- Michael G. Schmidt, Bettina von Dessauer, Carmen Benavente, Dona Benadof, Paulina Cifuentes, Alicia Elgueta, Claudia Duran, Maria S. Navarrete
- Impact of rapid screening for discontinuation of methicillin-resistant Staphylococcus aureus contact precautions
- Erica S. Shenoy, Hang Lee, Jessica A. Cotter, Winston Ware, Douglas Kelbaugh, Eric Weil, Rochelle P. Walensky, David C. Hooper
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?