• Acta orthopaedica · Aug 2009

    Positive nasal culture of methicillin-resistant Staphylococcus aureus (MRSA) is a risk factor for surgical site infection in orthopedics.

    • Koichi Yano, Yukihide Minoda, Akira Sakawa, Yoshihiro Kuwano, Kyoko Kondo, Wakaba Fukushima, and Koichi Tada.
    • Department of Orthopaedic Surgery, Kansai Rosai Hospital, Hyogo, Japan. koichiyano@hotmail.com
    • Acta Orthop. 2009 Aug 1; 80 (4): 486-90.

    BackgroundAlthough nasal carriage of MRSA has been identified as one of the risk factors for surgical site infection (SSI) with MRSA, there have been no reports of this in the orthopedics field.MethodsThis prospective observational cohort study included 2,423 consecutive patients who were admitted to our department over 26 months and who underwent orthopedic surgery. We examined the relationship between pre-existing nasal MRSA and subsequent occurrence of SSI with MRSA.Results63 patients (2.6%) had a positive nasal MRSA culture. 15 patients (0.6%) developed SSI with MRSA. The occurrence of SSI with MRSA in nasal MRSA carriers was significantly higher than that in non-carriers (4 out of 63 (6.3%) vs. 11 out of 2,360 (0.5%); p < 0.001) (adjusted OR: 11; 95% CI: 3-37; p = 0.001).InterpretationWe recommend appropriate treatment of patients who are nasal carriers of MRSA before orthopedic surgery.

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