Getting the drop on Staphylococcus aureus: Semiquantitative Staphylococcus aureus nasal colony reduction in orthopedic surgery reduces surgical site infection - 19/06/24
, Rivka Yosipovich, RN b, Vadim Benkovich, MD c, Tai Friesem, MD c, Ronit Nativ, MPH b, Orli Sagi, PhD d, Orly Shimoni, PharmD e, Abraham Borer, MD aRésumé |
Background |
Surgical site infection (SSI) is a frequent health care–associated infection. We aimed to reduce SSI risk after joint arthroplasty and spine surgery by reducing Staphylococcus aureus colonization burden with presurgery intranasal povidone-iodine (PVP-I) application in conjunction with skin antisepsis (“the intervention”).
Methods |
Retrospective case-control study; postintervention cohort versus a historical cohort. Adults who underwent joint arthroplasty or spine surgery during February 2018 through October 2021 (“post-intervention cohort”) included. In the analysis cases any patient who underwent surgery and developed SSI within 90 days postsurgery, controls had no SSI. Postintervention cohort data were compared with a similar retrospective 2016 to 2017 patient cohort that did not use intranasal PVP-I.
Results |
The postintervention cohort comprised 688 consecutive patients aged 65y/o, 48.8% male, 28 cases, and 660 controls. Relatively more cases than controls had diabetes mellitus (P = .019). There was a 39.6% eradication rate of S aureus nasal colonization post intranasal PVP-I (P < .0001). SSI rate was higher in patients positive versus those negative for S aureus on a 24-hour postsurgery nasal culture (P < .0001). The deep SSI rate per 100 operations postintervention versus the historical cohort decreased for all surgical procedures.
Conclusions |
Semiquantitative S aureus nasal colony reduction using intranasal PVP-I is effective for decreasing SSI rate in joint arthroplasty and spine surgery. In patients with presurgery S aureus nasal colonization additional intranasal PVP-I postsurgery application should be considered.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Post surgery (24 hours) S. aureus nasal colonization increases SSI risk three-fold. |
• | Intranasal 5% PVP-I provides semi-quantitative S. aureus nasal colony reduction. |
• | Pre joint / spine surgery intranasal 5% PVP-I and 4% CHG bathing decrease SSI rate. |
Key Words : 5% Povidone-Iodine, 4% Chlorhexidine gluconate, Joint arthroplasty, Spine surgery, Colonization
Plan
| Conflicts of interest: None to report. |
Vol 52 - N° 7
P. 785-789 - juillet 2024 Retour au numéro
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