Premier Applied Sciences, Premier, Charlotte, North Carolina.
Health Economics and Outcomes Research, Pfizer, Collegeville, Pennsylvania.
Infect Control Hosp Epidemiol. 2022 Jan;43(1):64-71. doi: 10.1017/ice.2021.65. Epub 2021 May 26.
To assess the 180-day incidence of Staphylococcus aureus infections following orthopedic surgeries using microbiology cultures.
Retrospective observational epidemiology study.
National administrative hospital database.
Adult patients with an elective admission undergoing orthopedic surgeries in the inpatient and hospital-based outpatient settings discharged between July 1, 2010, and June 30, 2015.
Patients were identified from 181 hospitals reporting microbiology results to the Premier Healthcare Database. Orthopedic surgeries were defined using International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) procedure and current procedural terminology (CPT) codes. Microbiology cultures and ICD-9/10 diagnosis codes identified surgical site infections (SSIs), bloodstream infections (BSIs), and other infections associated postoperatively (eg, respiratory and urinary tract infections).
Among 359,268 inpatient orthopedic surgical encounters, the S. aureus infection incidence was 1.13%: SSI, 0.68%; BSI, 0.28%; and other types, 0.17%. Among 292,011 outpatient encounters, the S. aureus incidence was 0.78%: SSI, 0.55%; BSI, 0.12%; and other types, 0.11%. Methicillin-resistant S. aureus (MRSA) infections accounted for 46% and 44% in the respective settings. Plastic/hand-limb reattachment and amputation had the highest overall S. aureus incidence in both settings. S. aureus was the most commonly isolated microorganism among culture-confirmed SSIs (48.0%) and BSIs (35.0%), followed by other Enterobacteriaceae (14.0%) for SSIs and Escherichia spp (12.5%) for BSIs.
These findings suggest that S. aureus infections continue to be an important contributor to the burden of postoperative infections after inpatient and outpatient orthopedic procedures.
通过微生物培养评估骨科手术后金黄色葡萄球菌感染的 180 天发生率。
回顾性观察性流行病学研究。
国家行政医院数据库。
2010 年 7 月 1 日至 2015 年 6 月 30 日期间，在住院和医院门诊环境下接受择期入院骨科手术的成年患者。
从向 Premier Healthcare Database 报告微生物学结果的 181 家医院中确定患者。骨科手术使用国际疾病分类，第九修订版，临床修正（ICD-9-CM）程序和当前手术术语（CPT）代码定义。微生物培养物和 ICD-9/10 诊断代码确定手术部位感染（SSI）、血流感染（BSI）和其他术后相关感染（例如呼吸道和尿路感染）。
在 359268 例住院骨科手术中，金黄色葡萄球菌感染发生率为 1.13%：SSI 为 0.68%；BSI 为 0.28%；其他类型为 0.17%。在 292011 例门诊手术中，金黄色葡萄球菌的发生率为 0.78%：SSI 为 0.55%；BSI 为 0.12%；其他类型为 0.11%。在这两个环境中，耐甲氧西林金黄色葡萄球菌（MRSA）感染分别占 46%和 44%。整形/手-肢再附着和截肢在两个环境中均具有最高的金黄色葡萄球菌总体发生率。金黄色葡萄球菌是经培养证实的 SSI（48.0%）和 BSI（35.0%）中最常见的分离微生物，其次是其他肠杆菌科（SSI 为 14.0%）和大肠埃希氏菌（BSI 为 12.5%）。
这些发现表明，金黄色葡萄球菌感染仍然是住院和门诊骨科手术后术后感染负担的重要原因。
