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Staphylococcus aureus infections following knee and hip prosthesis insertion procedures

Arduino, Jean M., Kaye, Keith S., Reed, Shelby D., Peter, Senaka A., Sexton, Daniel J., Chen, Luke F., Hardy, N. Chantelle, Tong, Steven Y. C., Smugar, Steven S., Fowler, Vance G., Jr. and Anderson, Deverick J. (2015). Staphylococcus aureus infections following knee and hip prosthesis insertion procedures. Antimicrobial Resistance and Infection Control,4(13).

Document type: Journal Article
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IRMA ID 11381xPUB98
NHMRC Grant No. 1065736
Title Staphylococcus aureus infections following knee and hip prosthesis insertion procedures
Author Arduino, Jean M.
Kaye, Keith S.
Reed, Shelby D.
Peter, Senaka A.
Sexton, Daniel J.
Chen, Luke F.
Hardy, N. Chantelle
Tong, Steven Y. C.
Smugar, Steven S.
Fowler, Vance G., Jr.
Anderson, Deverick J.
Journal Name Antimicrobial Resistance and Infection Control
Publication Date 2015
Volume Number 4
Issue Number 13
ISSN 2047-2994   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84938484276
Total Pages 7
Place of Publication United Kingdom
Publisher BioMed Central Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Staphylococcus aureus is the most common and most important pathogen following knee and hip arthroplasty procedures. Understanding the epidemiology of invasive S. aureus infections is important to quantify this serious complication.

Methods

This nested retrospective cohort analysis included adult patients who had undergone insertion of knee or hip prostheses with clean or clean-contaminated wound class at 11 hospitals between 2003–2006. Invasive S. aureus infections, non-superficial incisional surgical site infections (SSIs) and blood stream infections (BSIs), were prospectively identified following each procedure. Prevalence rates, per 100 procedures, were estimated.

Results
13,719 prosthetic knee (62%) and hip (38%) insertion procedures were performed. Of 92 invasive S. aureus infections identified, SSIs were more common (80%) than SSI and BSI (10%) or BSI alone (10%). The rate of invasive S. aureus infection/100 procedures was 0.57 [95% CI: 0.43-0.73] for knee insertion and 0.83 [95% CI: 0.61-1.08] for hip insertion. More than half (53%) were methicillin-resistant. Median time-to-onset of infection was 34 and 26 days for knee and hip insertion, respectively. Infection was associated with higher National Healthcare Safety Network risk index (p ≤ 0.0001).

Conclusions

Post-operative invasive S. aureus infections were rare, but difficult-to-treat methicillin-resistant infections were relatively common. Optimizing preventative efforts may greatly reduce the healthcare burden associated with S. aureus infections.
Keywords S. aureus infections
Hip prosthesis
Knee prosthesis
Epidemiology
Retrospective cohort
DOI http://dx.doi.org/10.1186/s13756-015-0057-4   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License
URL https://creativecommons.org/licenses/by/4.0/au


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