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全膝关节置换患者耐甲氧西林金黄色葡萄球菌(MRSA)定植的患病率及其人口统计学相关因素

Prevalence and demographic correlates of Methicillin-Resistant Staphylococcus aureus (MRSA) colonization in patients undergoing total knee replacement.

作者信息

Tiwari Anjali, Goyal Ravi, Sharma Gaurav, Nadange Shyam, Bagaria Vaibhav

机构信息

Department of Orthopedic Surgery, Sir H N Reliance Foundation Hospital, Girgaum, Mumbai 400004, Maharashtra, India.

出版信息

SICOT J. 2025;11:41. doi: 10.1051/sicotj/2025039. Epub 2025 Jul 21.

Abstract

BACKGROUND

Methicillin-resistant Staphylococcus aureus (MRSA) remains a significant concern in orthopedic surgery, particularly in total knee replacement (TKR), where infection can lead to severe complications. In procedures like TKR, where implants act as a foreign body and potential surface for biofilm formation, infections can lead to severe complications, including delayed healing, and implant failure, and often need multiple revision surgeries. Screening for MRSA before surgery has become a standard practice in many hospitals to reduce the risk of infection. This study aims to evaluate the prevalence of MRSA in patients undergoing TKR and analyze demographic characteristics.

METHODS

A retrospective analysis was conducted on patients scheduled for TKR. Demographic data, including age, gender, and other relevant clinical information, were extracted from the patient's medical records. MRSA screening was performed as part of the preoperative protocol, and the results were recorded. Descriptive statistics were used to summarize the data and calculate the prevalence of MRSA.

RESULTS

A total of 938 patients underwent MRSA screening prior to TKR. The mean age was 67.25 years (median: 68; range: 33-87). The majority of patients were female, accounting for 706 (75.0%), while 232 (25.0%) were male. MRSA test results revealed that 938 (99.3%) patients tested negative, whereas 6 (0.7%) tested positive. Among MRSA-positive patients, all were aged 60 years or older, suggesting a potential correlation between advanced age and MRSA positivity.

CONCLUSION

This study found a low MRSA prevalence (0.7%) in TKR patients, with all cases occurring in individuals aged ≥60 years. The findings advocate prioritizing preoperative screening in older patients to optimize resource use in low-prevalence settings and highlight the need to investigate TKR-specific risk factors for tailored infection control strategies.

摘要

背景

耐甲氧西林金黄色葡萄球菌(MRSA)在骨科手术中仍然是一个重大问题,尤其是在全膝关节置换术(TKR)中,感染可能导致严重并发症。在TKR等手术中,植入物作为异物和生物膜形成的潜在表面,感染可导致严重并发症,包括愈合延迟和植入物失败,并且通常需要多次翻修手术。术前筛查MRSA已成为许多医院降低感染风险的标准做法。本研究旨在评估接受TKR患者中MRSA的患病率,并分析人口统计学特征。

方法

对计划进行TKR的患者进行回顾性分析。从患者病历中提取人口统计学数据,包括年龄、性别和其他相关临床信息。作为术前方案的一部分进行MRSA筛查,并记录结果。使用描述性统计来汇总数据并计算MRSA的患病率。

结果

共有938例患者在TKR术前进行了MRSA筛查。平均年龄为67.25岁(中位数:68岁;范围:33 - 87岁)。大多数患者为女性,占706例(75.0%),而男性为232例(25.0%)。MRSA检测结果显示,938例(99.3%)患者检测为阴性,而6例(0.7%)检测为阳性。在MRSA阳性患者中,所有患者年龄均在60岁及以上,表明高龄与MRSA阳性之间可能存在关联。

结论

本研究发现TKR患者中MRSA患病率较低(0.7%),所有病例均发生在年龄≥60岁的个体中。研究结果主张在老年患者中优先进行术前筛查,以在低患病率环境中优化资源利用,并强调需要研究TKR特定的危险因素,以制定针对性的感染控制策略。

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