Service d'orthopédie-traumatologie, hôpital européen Georges-Pompidou, Paris, France; Service d'orthopédie-traumatologie, hôpital européen Georges-Pompidou, université Paris-Descartes, Paris, France.
Service d'orthopédie-traumatologie, hôpital européen Georges-Pompidou, Paris, France; Service d'orthopédie-traumatologie, hôpital européen Georges-Pompidou, université Paris-Descartes, Paris, France.
Orthop Traumatol Surg Res. 2020 Oct;106(6):1175-1181. doi: 10.1016/j.otsr.2020.01.013. Epub 2020 May 1.
In spinal surgery, incidence of surgical site infections (SSI) is estimated between 1 and 10%. It results in increased morbidity, mortality and cost of management. Individual Staphylococcus aureus (SA) decolonization has already proved efficiency to prevent those events in various surgical domains. The aim of this study was to evaluate a strategy of prevention of SSI and in particular the decolonization of the nasal carriage of SA by a protocol with Mupirocin application.
We conducted a bicentric observational study on 5314 spinal surgery patients over a seven-year period. In both center, we compared periods before and after implementation of two measures: modification of antibioprophylaxis and staphylococcus decolonization. Homogeneity of the different samples of patients was assessed through measure of individual and surgical variables. We measured monthly incidence of SSI and evaluated its evolution in order to assess efficiency of these interventions.
The incidence of SSI decreased by half, from 7.3% to 3% at the Beaujon Hospital and from 8.3% to 3.9% at the Georges-Pompidou European Hospital (GPEH). We do not observe any significant decrease of SA rate in these SSI.
We believe that Staphylococcus aureus decolonization should be recommended in spinal surgery, and should be combined with an overall improvement of the quality of care.
在脊柱手术中，手术部位感染（SSI）的发生率估计在 1%至 10%之间。这会导致发病率、死亡率和管理成本增加。个体金黄色葡萄球菌（SA）去定植已被证明在各种手术领域预防这些事件的有效性。本研究旨在评估一种预防 SSI 的策略，特别是通过莫匹罗星应用方案对 SA 鼻腔携带进行去定植。
我们在 7 年期间对 5314 例脊柱手术患者进行了一项双中心观察性研究。在两个中心，我们比较了实施两项措施前后的时期：抗生素预防和金黄色葡萄球菌去定植的修改。通过测量个体和手术变量来评估患者不同样本的同质性。我们测量了 SSI 的每月发生率，并评估了其变化，以评估这些干预措施的效果。
SSI 的发生率减半，从博让医院的 7.3%降至 3%，从乔治·蓬皮杜欧洲医院（GPEH）的 8.3%降至 3.9%。我们没有观察到这些 SSI 中 SA 率的显著下降。
我们认为金黄色葡萄球菌去定植应推荐用于脊柱手术，并应与整体护理质量的提高相结合。
