Staphylococcus aureus infections following knee and hip prosthesis insertion procedures

Jean Marie Arduino, Keith S Kaye, Shelby Reed, Senaka A Peter, Daniel Sexton, Luke Chen, N Chantelle Hardy, Steven Tong, Steven S Smugar, Vance Fowler Jr, Deverick J Anderson

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    Abstract

    Background: Staphylococcus aureus is the most common and most important pathogen following knee and hip arthroplasty procedures. Understanding the epidemiology of invasive S. aureus infections is important to quantify this serious complication. 


    Methods: This nested retrospective cohort analysis included adult patients who had undergone insertion of knee or hip prostheses with clean or clean-contaminated wound class at 11 hospitals between 2003-2006. Invasive S. aureus infections, non-superficial incisional surgical site infections (SSIs) and blood stream infections (BSIs), were prospectively identified following each procedure. Prevalence rates, per 100 procedures, were estimated. 


    Results: 13,719 prosthetic knee (62%) and hip (38%) insertion procedures were performed. Of 92 invasive S. aureus infections identified, SSIs were more common (80%) than SSI and BSI (10%) or BSI alone (10%). The rate of invasive S. aureus infection/100 procedures was 0.57 [95% CI: 0.43-0.73] for knee insertion and 0.83 [95% CI: 0.61-1.08] for hip insertion. More than half (53%) were methicillin-resistant. Median time-to-onset of infection was 34 and 26 days for knee and hip insertion, respectively. Infection was associated with higher National Healthcare Safety Network risk index (p ≤ 0.0001). 


    Conclusions: Post-operative invasive S. aureus infections were rare, but difficult-to-treat methicillin-resistant infections were relatively common. Optimizing preventative efforts may greatly reduce the healthcare burden associated with S. aureus infections.

    Original languageEnglish
    Pages (from-to)1-7
    Number of pages7
    JournalAntimicrobial Resistance and Infection Control
    Volume4
    Issue number13
    DOIs
    Publication statusPublished - 15 May 2015

    Fingerprint

    Knee Prosthesis
    Hip Prosthesis
    Staphylococcus aureus
    Infection
    Hip
    Surgical Wound Infection
    Methicillin Resistance
    Knee
    Delivery of Health Care
    Knee Replacement Arthroplasties

    Cite this

    Arduino, J. M., Kaye, K. S., Reed, S., Peter, S. A., Sexton, D., Chen, L., ... Anderson, D. J. (2015). Staphylococcus aureus infections following knee and hip prosthesis insertion procedures. Antimicrobial Resistance and Infection Control, 4(13), 1-7. https://doi.org/10.1186/s13756-015-0057-4
    Arduino, Jean Marie ; Kaye, Keith S ; Reed, Shelby ; Peter, Senaka A ; Sexton, Daniel ; Chen, Luke ; Hardy, N Chantelle ; Tong, Steven ; Smugar, Steven S ; Fowler Jr, Vance ; Anderson, Deverick J. / Staphylococcus aureus infections following knee and hip prosthesis insertion procedures. In: Antimicrobial Resistance and Infection Control. 2015 ; Vol. 4, No. 13. pp. 1-7.
    @article{23bc44aaf41b4314a160e8a20db95b05,
    title = "Staphylococcus aureus infections following knee and hip prosthesis insertion procedures",
    abstract = "Background: Staphylococcus aureus is the most common and most important pathogen following knee and hip arthroplasty procedures. Understanding the epidemiology of invasive S. aureus infections is important to quantify this serious complication.  Methods: This nested retrospective cohort analysis included adult patients who had undergone insertion of knee or hip prostheses with clean or clean-contaminated wound class at 11 hospitals between 2003-2006. Invasive S. aureus infections, non-superficial incisional surgical site infections (SSIs) and blood stream infections (BSIs), were prospectively identified following each procedure. Prevalence rates, per 100 procedures, were estimated.  Results: 13,719 prosthetic knee (62{\%}) and hip (38{\%}) insertion procedures were performed. Of 92 invasive S. aureus infections identified, SSIs were more common (80{\%}) than SSI and BSI (10{\%}) or BSI alone (10{\%}). The rate of invasive S. aureus infection/100 procedures was 0.57 [95{\%} CI: 0.43-0.73] for knee insertion and 0.83 [95{\%} CI: 0.61-1.08] for hip insertion. More than half (53{\%}) were methicillin-resistant. Median time-to-onset of infection was 34 and 26 days for knee and hip insertion, respectively. Infection was associated with higher National Healthcare Safety Network risk index (p ≤ 0.0001).  Conclusions: Post-operative invasive S. aureus infections were rare, but difficult-to-treat methicillin-resistant infections were relatively common. Optimizing preventative efforts may greatly reduce the healthcare burden associated with S. aureus infections.",
    author = "Arduino, {Jean Marie} and Kaye, {Keith S} and Shelby Reed and Peter, {Senaka A} and Daniel Sexton and Luke Chen and Hardy, {N Chantelle} and Steven Tong and Smugar, {Steven S} and {Fowler Jr}, Vance and Anderson, {Deverick J}",
    note = "Dr. Tong was supported by an Australian-American Fulbright Scholarship, a Royal Australian College of Physicians Bayer Australia Medical Research Fellowship, and is an Australian National Health and Medical Research Council Career Development Fellow (1065736).",
    year = "2015",
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    Arduino, JM, Kaye, KS, Reed, S, Peter, SA, Sexton, D, Chen, L, Hardy, NC, Tong, S, Smugar, SS, Fowler Jr, V & Anderson, DJ 2015, 'Staphylococcus aureus infections following knee and hip prosthesis insertion procedures', Antimicrobial Resistance and Infection Control, vol. 4, no. 13, pp. 1-7. https://doi.org/10.1186/s13756-015-0057-4

    Staphylococcus aureus infections following knee and hip prosthesis insertion procedures. / Arduino, Jean Marie; Kaye, Keith S; Reed, Shelby; Peter, Senaka A; Sexton, Daniel; Chen, Luke; Hardy, N Chantelle; Tong, Steven; Smugar, Steven S; Fowler Jr, Vance; Anderson, Deverick J.

    In: Antimicrobial Resistance and Infection Control, Vol. 4, No. 13, 15.05.2015, p. 1-7.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Staphylococcus aureus infections following knee and hip prosthesis insertion procedures

    AU - Arduino, Jean Marie

    AU - Kaye, Keith S

    AU - Reed, Shelby

    AU - Peter, Senaka A

    AU - Sexton, Daniel

    AU - Chen, Luke

    AU - Hardy, N Chantelle

    AU - Tong, Steven

    AU - Smugar, Steven S

    AU - Fowler Jr, Vance

    AU - Anderson, Deverick J

    N1 - Dr. Tong was supported by an Australian-American Fulbright Scholarship, a Royal Australian College of Physicians Bayer Australia Medical Research Fellowship, and is an Australian National Health and Medical Research Council Career Development Fellow (1065736).

    PY - 2015/5/15

    Y1 - 2015/5/15

    N2 - Background: Staphylococcus aureus is the most common and most important pathogen following knee and hip arthroplasty procedures. Understanding the epidemiology of invasive S. aureus infections is important to quantify this serious complication.  Methods: This nested retrospective cohort analysis included adult patients who had undergone insertion of knee or hip prostheses with clean or clean-contaminated wound class at 11 hospitals between 2003-2006. Invasive S. aureus infections, non-superficial incisional surgical site infections (SSIs) and blood stream infections (BSIs), were prospectively identified following each procedure. Prevalence rates, per 100 procedures, were estimated.  Results: 13,719 prosthetic knee (62%) and hip (38%) insertion procedures were performed. Of 92 invasive S. aureus infections identified, SSIs were more common (80%) than SSI and BSI (10%) or BSI alone (10%). The rate of invasive S. aureus infection/100 procedures was 0.57 [95% CI: 0.43-0.73] for knee insertion and 0.83 [95% CI: 0.61-1.08] for hip insertion. More than half (53%) were methicillin-resistant. Median time-to-onset of infection was 34 and 26 days for knee and hip insertion, respectively. Infection was associated with higher National Healthcare Safety Network risk index (p ≤ 0.0001).  Conclusions: Post-operative invasive S. aureus infections were rare, but difficult-to-treat methicillin-resistant infections were relatively common. Optimizing preventative efforts may greatly reduce the healthcare burden associated with S. aureus infections.

    AB - Background: Staphylococcus aureus is the most common and most important pathogen following knee and hip arthroplasty procedures. Understanding the epidemiology of invasive S. aureus infections is important to quantify this serious complication.  Methods: This nested retrospective cohort analysis included adult patients who had undergone insertion of knee or hip prostheses with clean or clean-contaminated wound class at 11 hospitals between 2003-2006. Invasive S. aureus infections, non-superficial incisional surgical site infections (SSIs) and blood stream infections (BSIs), were prospectively identified following each procedure. Prevalence rates, per 100 procedures, were estimated.  Results: 13,719 prosthetic knee (62%) and hip (38%) insertion procedures were performed. Of 92 invasive S. aureus infections identified, SSIs were more common (80%) than SSI and BSI (10%) or BSI alone (10%). The rate of invasive S. aureus infection/100 procedures was 0.57 [95% CI: 0.43-0.73] for knee insertion and 0.83 [95% CI: 0.61-1.08] for hip insertion. More than half (53%) were methicillin-resistant. Median time-to-onset of infection was 34 and 26 days for knee and hip insertion, respectively. Infection was associated with higher National Healthcare Safety Network risk index (p ≤ 0.0001).  Conclusions: Post-operative invasive S. aureus infections were rare, but difficult-to-treat methicillin-resistant infections were relatively common. Optimizing preventative efforts may greatly reduce the healthcare burden associated with S. aureus infections.

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    SN - 2047-2994

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