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Arthritis
Volume 2010 (2010), Article ID 924518, 4 pages
http://dx.doi.org/10.1155/2010/924518
Clinical Study

Staphylococcus aureus Decolonization Protocol Decreases Surgical Site Infections for Total Joint Replacement

NYU-Hospital for Joint Diseases, 301 East 17th Street New York, NY 10003, USA

Received 14 August 2010; Revised 22 October 2010; Accepted 3 November 2010

Academic Editor: Burkhard Leeb

Copyright © 2010 Scott Hadley et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We investigated the effects of implementation of an institution-wide screening and decolonization protocol on the rates of deep surgical site infections (SSIs) in patients undergoing primary knee and hip arthroplasties. 2058 patients were enrolled in this study: 1644 patients in the treatment group and 414 in the control group. The treatment group attended preoperative admission testing (PAT) clinic where they were screened for MSSA and MRSA colonization. All patients were provided a 5-day course of nasal mupirocin and a single preoperative chlorhexidine shower. Additionally, patients colonized with MRSA received Vancomycin perioperative prophylaxis. The control group did not attend PAT nor receive mupirocin treatment and received either Ancef or Clindamycin for perioperative antibiotic prophylaxis. There were a total of 6 deep infections in the control group (1.45%) and 21 in the treatment group (1.28%); this represented a decrease of 13% ( 𝑃 = . 8 0 9 ) in the treatment versus control group. This decrease represented a positive trend in favor of staphylococcus screening, decolonization with mupirocin, and perioperative Vancomycin for known MRSA carriers.