Department of Orthopaedic Surgery, Kansai Rosai Hospital, Hyogo, Japan.
Acta Orthop. 2009 Aug;80(4):486-90. doi: 10.3109/17453670903110675.
Although nasal carriage of MRSA has been identified as one of the risk factors for surgical site infection (SSI) with MRSA, there have been no reports of this in the orthopedics field.
This prospective observational cohort study included 2,423 consecutive patients who were admitted to our department over 26 months and who underwent orthopedic surgery. We examined the relationship between pre-existing nasal MRSA and subsequent occurrence of SSI with MRSA.
63 patients (2.6%) had a positive nasal MRSA culture. 15 patients (0.6%) developed SSI with MRSA. The occurrence of SSI with MRSA in nasal MRSA carriers was significantly higher than that in non-carriers (4 out of 63 (6.3%) vs. 11 out of 2,360 (0.5%); p < 0.001) (adjusted OR: 11; 95% CI: 3-37; p = 0.001).
We recommend appropriate treatment of patients who are nasal carriers of MRSA before orthopedic surgery.
尽管鼻腔携带耐甲氧西林金黄色葡萄球菌（MRSA）已被确定为 MRSA 手术部位感染（SSI）的危险因素之一，但在骨科领域尚未有相关报道。
本前瞻性观察性队列研究纳入了 26 个月内我院骨科收治的 2423 例连续患者，对他们进行了研究。我们研究了术前鼻腔 MRSA 与术后 MRSA 所致 SSI 之间的关系。
63 例患者（2.6%）的鼻腔 MRSA 培养呈阳性。15 例患者（0.6%）发生了 MRSA 所致 SSI。鼻腔 MRSA 携带者中 MRSA 所致 SSI 的发生率明显高于非携带者（4/63（6.3%）比 11/2360（0.5%）；p<0.001）（校正 OR：11；95%CI：3-37；p=0.001）。
我们建议在骨科手术前对鼻腔携带 MRSA 的患者进行适当的治疗。
