A bundle that includes active surveillance, contact precaution for carriers, and cefazolin-based antimicrobial prophylaxis prevents methicillin-resistant Staphylococcus aureus infections in clean orthopedic surgery

Hideki Kawamura, Kazuaki Matsumoto, Akari Shigemi, Michiyo Orita, Aya Nakagawa, Satoko Nozima, Hiroyuki Tominaga, Takao Setoguchi, Setsuro Komiya, Koichi Tokuda, Junichiro Nishi

研究成果: Article査読

11 被引用数 (Scopus)

抄録

Background Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of orthopedic surgical site infections (SSIs). The aim of this study was to evaluate the effect of a bundle approach in the prevention of orthopedic MRSA SSIs. Material and Methods MRSA active surveillance and decolonization were performed preoperatively at our institution from July 2004 until 2007. In January 2008, a bundle approach comprising contact precautions for MRSA-positive patients and cefazolin-based antimicrobial prophylaxis (AMP) stewardship was implemented. Data on the prevalence of MRSA SSIs, antimicrobial use density, duration of AMP, and the use of an alcohol antiseptic agent (L/1,000 patient-days) were evaluated during 2 periods: July 2004-December 2007 (period A) and January 2008-December 2012 (period B). Results and Discussion The MRSA SSI rate during period B (0.97%; 19 out of 1,966) was significantly lower than that during period A (2.17%; 29 out of 1,333; P =.003). The infection rate correlated negatively with both the cefazolin antimicrobial use density (r = -0.76; P =.0002) and the use of an alcohol antiseptic agent (r = -0.68; P =.002). Conclusions An infection-prevention bundle consisting of contact precautions for carriers and AMP stewardship in addition to active surveillance was associated with a significant decrease in the incidence of orthopedic MRSA SSIs.

本文言語English
ページ(範囲)210-214
ページ数5
ジャーナルAmerican Journal of Infection Control
44
2
DOI
出版ステータスPublished - 2016 2 1
外部発表はい

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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