Is nasal carriage of Staphylococcus aureus the main acquisition pathway for surgical-site infection in orthopaedic surgery?

Autor: J.-P. Fayard, Frédéric Farizon, J. Bejuy, Philippe Berthelot, J.-P. Passot, Florence Grattard, Frédéric Lucht, Bruno Pozzetto, R. Meley, Céline Cazorla
Rok vydání: 2010
Předmět:
Male
Microbiology (medical)
Staphylococcus aureus
medicine.medical_specialty
Micrococcaceae
Genotype
Mupirocin
Microbial Sensitivity Tests
medicine.disease_cause
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Medical microbiology
Risk Factors
medicine
Humans
Surgical Wound Infection
Prospective Studies
030212 general & internal medicine
Prospective cohort study
Nose
Aged
Molecular Epidemiology
0303 health sciences
biology
030306 microbiology
business.industry
Surgical wound
General Medicine
Middle Aged
Staphylococcal Infections
biology.organism_classification
DNA Fingerprinting
Bacterial Typing Techniques
Electrophoresis
Gel
Pulsed-Field
3. Good health
Surgery
Infectious Diseases
medicine.anatomical_structure
chemistry
Carrier State
Orthopedic surgery
Female
business
Zdroj: European Journal of Clinical Microbiology & Infectious Diseases. 29:373-382
ISSN: 1435-4373
0934-9723
DOI: 10.1007/s10096-009-0867-5
Popis: The endogenous or exogenous origin of Staphylococcus aureus, responsible for orthopaedic surgical-site infections (SSI), remains debated. We conducted a multicentre prospective cohort study to analyse the respective part of exogenous contamination and endogenous self-inoculation by S. aureus during elective orthopaedic surgery. The nose of each consecutive patient was sampled before surgery. Strains of S. aureus isolated from the nose and the wound, in the case of SSI, were compared by antibiotypes or pulsed-field gel electrophoresis (PFGE). A total of 3,908 consecutive patients undergoing orthopaedic surgery were included. Seventy-seven patients developed an SSI (2%), including 22 related to S. aureus (0.6%). S. aureus was isolated from the nose of 790 patients (20.2%) at the time of surgery. In the multivariate analysis, S. aureus nasal carriage was found to be a risk factor for S. aureus SSI in orthopaedic surgery. However, only nine subjects exhibiting S. aureus SSI had been found to be carriers before surgery: when compared, three pairs of strains were considered to be different and six similar. In most cases of S. aureus SSI, either an endogenous origin could not be demonstrated or pre-operative nasal colonisation retrieved a strain that was different from the one recovered from the surgical site.
Databáze: OpenAIRE
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