Department of Medicine, Division of Infectious Disease, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15206, USA.
J Arthroplasty. 2011 Dec;26(8):1501-7. doi: 10.1016/j.arth.2011.03.014. Epub 2011 Apr 19.
We quantified surgical site infections (SSIs) after preoperative screening/selective decolonization before elective total joint arthroplasty (TJA) with 2-year follow-up and 2 controls. Concurrent controls (n = 2284) were patients of surgeons not participating in screening/decolonization. Preintervention controls (n = 741) were patients of participating surgeons who underwent TJA the previous year. Staphylococcus aureus nasal carriers (321/1285 [25%]) used intranasal mupirocin and chlorhexidine baths as outpatients. Staphylococcal SSIs occurred in no intervention patients (0/321) and 19 concurrent controls. If all SSIs occurred in carriers and 25% of controls were carriers, staphylococcal SSI rate would have been 3.3% in controls (19/571; P = .001). Overall SSI rate decreased from 2.7% (20/741) in preintervention controls to 1.2% (17/1440) in intervention patients (P = .009). Preoperative screening/selective decolonization was associated with fewer SSIs after elective TJA.
我们对接受选择性去定植术前筛查的择期全关节置换术（TJA）患者进行了为期 2 年的随访，并设立了 2 个对照，量化了手术部位感染（SSI）的发生情况。同期对照（n=2284）为未参与筛查/去定植术的外科医生的患者。干预前对照（n=741）为前一年接受参与筛查/去定植术的外科医生治疗的 TJA 患者。金黄色葡萄球菌鼻腔携带者（321/1285 [25%]）作为门诊患者接受了鼻腔莫匹罗星和洗必泰浴。非干预患者（0/321）和 19 例同期对照患者中均未发生葡萄球菌 SSI。如果所有 SSI 都发生在携带者身上，且 25%的对照患者是携带者，那么对照组的葡萄球菌 SSI 发生率为 3.3%（19/571；P=.001）。干预组的总体 SSI 发生率从干预前对照的 2.7%（20/741）下降至 1.2%（17/1440）（P=.009）。择期 TJA 前的筛查/选择性去定植与 SSI 减少相关。
