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Effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study

BACKGROUND: The bacterial source of surgical-site infections (SSIs) can have either endogenous and/or exogenous origins, and some studies have revealed that endogenous transmission is an important pathway for SSIs in orthopedic surgery. However, since the frequency of SSIs is low (0.5–4.7%), screeni...

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Autores principales: Kobayashi, Tatsuki, Ishikawa, Tetsuhiro, Katsuragi, Joe, Ota, Mitsutoshi, Omae, Takanori, Sasaki, Yasuhito, Tsurumi, Yousuke, Nomoto, Takashi, Ohtori, Seiji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163806/
https://www.ncbi.nlm.nih.gov/pubmed/37149570
http://dx.doi.org/10.1186/s12891-023-06471-1
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author Kobayashi, Tatsuki
Ishikawa, Tetsuhiro
Katsuragi, Joe
Ota, Mitsutoshi
Omae, Takanori
Sasaki, Yasuhito
Tsurumi, Yousuke
Nomoto, Takashi
Ohtori, Seiji
author_facet Kobayashi, Tatsuki
Ishikawa, Tetsuhiro
Katsuragi, Joe
Ota, Mitsutoshi
Omae, Takanori
Sasaki, Yasuhito
Tsurumi, Yousuke
Nomoto, Takashi
Ohtori, Seiji
author_sort Kobayashi, Tatsuki
collection PubMed
description BACKGROUND: The bacterial source of surgical-site infections (SSIs) can have either endogenous and/or exogenous origins, and some studies have revealed that endogenous transmission is an important pathway for SSIs in orthopedic surgery. However, since the frequency of SSIs is low (0.5–4.7%), screening all surgery patients is labor-intensive and cost-prohibitive. The goal of this study was to better understand how to improve the efficacy of nasal culture screening in preventing SSIs. METHODS: Nasal cultures for 1616 operative patients over a 3-year period were evaluated for the presence of nasal bacterial microbiota and the species identity. We also investigated the medical factors that influence colonization and evaluated the ratio of agreement between nasal cultures and SSI-causing bacteria. RESULTS: In a survey of 1616 surgical cases, 1395 (86%) were normal microbiota (NM), 190 (12%) were MSSA carriers, and 31 (2%) were MRSA carriers. The risk factors for MRSA carriers were significantly higher than the NM group in patients with a history of hospitalization (13 [41.9%], p = 0.015), patients who had been admitted to a nursing facility (4 [12.9%], p = 0.005), and patients who were > 75 years of age (19 [61.3%], p = 0.021). The incidence of SSIs was significantly higher in the MSSA group (17/190 [8.4%]) than the NM group (10/1395 [0.7%], p = 0.00). The incidence of SSIs in the MRSA group (1/31 [3.2%]) tended to be higher than that in the NM group, but there was no statistically significant difference (p = 0.114). The concordance rate between causative bacteria of SSI and species present in nasal cultures was 53% (13/25 cases). CONCLUSIONS: The results of our study suggest screening patients with a history of past hospitalization, a history of admission in a long-term care facility, and older than 75 to reduce SSIs. TRIAL REGISTRATION: This study was approved by the institutional review board of the authors’ affiliated institutions (the ethics committee of Sanmu Medical Center, 2016-02).
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spelling pubmed-101638062023-05-07 Effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study Kobayashi, Tatsuki Ishikawa, Tetsuhiro Katsuragi, Joe Ota, Mitsutoshi Omae, Takanori Sasaki, Yasuhito Tsurumi, Yousuke Nomoto, Takashi Ohtori, Seiji BMC Musculoskelet Disord Research BACKGROUND: The bacterial source of surgical-site infections (SSIs) can have either endogenous and/or exogenous origins, and some studies have revealed that endogenous transmission is an important pathway for SSIs in orthopedic surgery. However, since the frequency of SSIs is low (0.5–4.7%), screening all surgery patients is labor-intensive and cost-prohibitive. The goal of this study was to better understand how to improve the efficacy of nasal culture screening in preventing SSIs. METHODS: Nasal cultures for 1616 operative patients over a 3-year period were evaluated for the presence of nasal bacterial microbiota and the species identity. We also investigated the medical factors that influence colonization and evaluated the ratio of agreement between nasal cultures and SSI-causing bacteria. RESULTS: In a survey of 1616 surgical cases, 1395 (86%) were normal microbiota (NM), 190 (12%) were MSSA carriers, and 31 (2%) were MRSA carriers. The risk factors for MRSA carriers were significantly higher than the NM group in patients with a history of hospitalization (13 [41.9%], p = 0.015), patients who had been admitted to a nursing facility (4 [12.9%], p = 0.005), and patients who were > 75 years of age (19 [61.3%], p = 0.021). The incidence of SSIs was significantly higher in the MSSA group (17/190 [8.4%]) than the NM group (10/1395 [0.7%], p = 0.00). The incidence of SSIs in the MRSA group (1/31 [3.2%]) tended to be higher than that in the NM group, but there was no statistically significant difference (p = 0.114). The concordance rate between causative bacteria of SSI and species present in nasal cultures was 53% (13/25 cases). CONCLUSIONS: The results of our study suggest screening patients with a history of past hospitalization, a history of admission in a long-term care facility, and older than 75 to reduce SSIs. TRIAL REGISTRATION: This study was approved by the institutional review board of the authors’ affiliated institutions (the ethics committee of Sanmu Medical Center, 2016-02). BioMed Central 2023-05-06 /pmc/articles/PMC10163806/ /pubmed/37149570 http://dx.doi.org/10.1186/s12891-023-06471-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Kobayashi, Tatsuki
Ishikawa, Tetsuhiro
Katsuragi, Joe
Ota, Mitsutoshi
Omae, Takanori
Sasaki, Yasuhito
Tsurumi, Yousuke
Nomoto, Takashi
Ohtori, Seiji
Effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study
title Effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study
title_full Effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study
title_fullStr Effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study
title_full_unstemmed Effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study
title_short Effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study
title_sort effective screening methods to prevent surgical site infections in orthopedic surgery: an observational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163806/
https://www.ncbi.nlm.nih.gov/pubmed/37149570
http://dx.doi.org/10.1186/s12891-023-06471-1
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