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 language | English |
|---|---|
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | Antimicrobial Resistance and Infection Control |
| Volume | 4 |
| Issue number | 13 |
| DOIs | |
| Publication status | Published - 15 May 2015 |
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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 journal › Article › Research › peer-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.
UR - http://www.scopus.com/inward/record.url?scp=84938484276&partnerID=8YFLogxK
U2 - 10.1186/s13756-015-0057-4
DO - 10.1186/s13756-015-0057-4
M3 - Article
VL - 4
SP - 1
EP - 7
JO - Antimicrobial Resistance and Infection Control
JF - Antimicrobial Resistance and Infection Control
SN - 2047-2994
IS - 13
ER -