Nasal Swab Screening for Staphylococcus aureus in Spinal Deformity Patients Treated With Growing Rods
| Autor: | June C. Smith, Scott J. Luhmann |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty Pathology Staphylococcus aureus Cefazolin medicine.disease_cause 03 medical and health sciences 0302 clinical medicine Medicine Humans Mass Screening Surgical Wound Infection Orthopedics and Sports Medicine Antibiotic prophylaxis Child Retrospective Studies 030222 orthopedics business.industry Clindamycin Preoperative screening Infant Retrospective cohort study General Medicine Antibiotic Prophylaxis Staphylococcal Infections Surgery Anti-Bacterial Agents Nasal Swab Pediatrics Perinatology and Child Health Spinal deformity business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of pediatric orthopedics. 39(9) |
| ISSN: | 1539-2570 |
| Popis: | Surgical-site infections are one of the most concerning complications in patients treated with growing rods (GR). The purpose of this study was to evaluate the use of preoperative screening for Staphylococcus aureus (SA) for all growing spine procedures, and if this would permit alteration of prophylactic antibiotics to cover the identified resistances.All patients were identified who had SA screening during the course of GR treatment. In otal, 34 patients [23 neuromuscular (NMS), 4 congenital, 4 idiopathic scoliosis (IS), and 3 syndromic] were identified who had 111 preoperative screenings [79 lengthenings, 23 insertions, 6 revisions, and 3 conversions to posterior spinal fusions (PSF)]. Mean age at GR insertion was 5.5 years (2 to 11 y).There were 11 methicillin-resistant Staphylococcus aureus (MRSA) "+" screenings in 6 patients (5 NMS, 1 IS): 3 in 3 patients before GR insertion and 8 in 3 patients (all 3 were negative at GR insertion screening) at subsequent surgeries. There were 23 methicillin-sensitive Staphylococcus aureus (MSSA) "+" screenings in 12 patients (7 NMS, 2 congenital, 2 IS, 1 syndromic): 2 in 2 patients before GR insertion and 21 in 10 patients at subsequent surgeries (18 lengthenings, 3 revisions). Overall, 13 patients (3 MRSA+10 MSSA) were initially negative but screened positive for the first time at a subsequent surgery (12 lengthenings, 1 GR to PSF). All patients (n=5) with positive screenings before GR insertion were in patients with NMS (3 MRSA, 2 MSSA). On the basis of sensitivities, 9 patients demonstrated SA resistance to cefazolin (8 MRSA and 1 MSSA) and 6 to clindamycin (5 MRSA and 1 MSSA). Hence, if cefazolin was routinely used for all patients 26.5% of patients (9/34) would have been inadequately covered at some point during their GR treatment; clindamycin, 17.7% (6/34).The use of SA nasal swab screening in GR patients identified 9 patients (26.5%) whose prophylactic antibiotics (cefazolin) could be altered to permit appropriate SA coverage.Level IV-retrospective case series. |
| Databáze: | OpenAIRE |
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