Highlights
- •Surveillance is used to discover pathogens of surgical site infection posthip and -knee arthroplasty.
- •Infections after knee arthroplasty tend to occur later versus hip arthroplasty.
- •Preoperative colonization with methicillin-resistant Staphylococcus aureus (MRSA) is more likely to cause an MRSA surgical site infection.
Background
Knee and hip replacements are an effective intervention for improving quality of life.
Rates of these surgeries in North America are growing, coinciding with increasing
obesity and an aging population.
Methods
Alberta Health Services' infection prevention and control program collects data prospectively
on surgical site infections (SSIs) after primary total hip and knee arthroplasty completed
in Alberta, Canada. We reviewed all SSIs within 180 days of surgical procedures between
March 1, 2012, and June 30, 2014.
Results
There were 312 SSI cases reviewed. Rates of SSI (per 100 procedures) were 1.77 and
1.26 for hip and knee arthroplasties, respectively. Seventy-nine percent of infections
occurred within 30 days postoperatively. Stratified by time to infection, larger proportions
of knee SSIs occurred after 30 days versus hip SSI. Colonization with methicillin-resistant
Staphylococcus aureus (MRSA) was associated with subsequent infection (odds ratio, 40; 95% confidence interval,
10.2-154.2). We have identified important characteristics that may be helpful for
determining optimal prevention strategies.
Conclusions
Intensive postoperative follow-up within 30 days of knee arthroplasty may help to
identify SSI early, allowing for prompt treatment and avoiding the need for invasive
therapy, such as surgery for hardware revision. Decolonization techniques may decrease
subsequent MRSA SSI in colonized patients.
Key Words
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Article info
Publication history
Published online: May 07, 2016
Footnotes
Conflicts of Interest: None to report.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
