Journal article
Staphylococcus aureus colonization and surgical site infections among patients undergoing surgical fixation for acute fractures
Infection control and hospital epidemiology, Vol.46(4), pp.384-390
04/2025
DOI: 10.1017/ice.2024.233
PMCID: PMC12015622
PMID: 39949120
Appears in UI Libraries Support Open Access
Abstract
To identify risk factors for methicillin-susceptible (MSSA) and methicillin-resistant
(MRSA) nasal carriage and surgical site infection (SSI) among patients undergoing fracture fixation procedures who were included in a quality improvement protocol involving screening patients for
nasal carriage and treating carriers with intranasal mupirocin and chlorhexidine bathing.
Retrospective cohort study.
Level 1 trauma center.
1,254 adults who underwent operative fixation of 1,298 extremity or pelvis fractures between 8/1/2014 - 7/31/2017.
We calculated rates of
nasal carriage and SSI. We used multivariable stepwise logistic regression and selected the final models based on Akaike information criterion.
Of the 1,040 screened first procedures, 262 (25.19%) were performed on
nasal carriers: 211 (20.29%) on MSSA carriers and 51 (4.90%) on MRSA carriers. Long-term care facility residence (odds ratio [OR] 3.38; 95% confidence interval [CI] 1.17-9.76) was associated with MRSA nasal carriage. After adjusting for statistically and clinically significant variables, MRSA carriage was significantly associated with any SSI (OR 4.58; 95% CI 1.63-12.88),
SSI (OR 10.11; 95% CI 3.25-31.42), and MRSA SSI (OR 27.25; 95% CI 5.33-139.24), whereas MSSA carriage was not. Among
carriers, any chlorhexidine use was documented for 232 (88.55%), and any intranasal mupirocin was documented for 85 (40.28%) MSSA carriers and 33 (64.71%) MRSA carriers.
MRSA carriage was associated with a significant risk of SSI after operative fracture fixation. Many carriers did not undergo decolonization, suggesting that a simplified decolonization protocol is needed.
Details
- Title: Subtitle
- Staphylococcus aureus colonization and surgical site infections among patients undergoing surgical fixation for acute fractures
- Creators
- Megan Ahmann - University of IowaJocelyn Compton - University of IowaJean Pottinger - University of IowaRichard Uhlenhopp - University of IowaMelissa Ward - University of IowaAmbar Haleem - University of IowaMichael Willey - University of IowaMarin Schweizer - University of IowaLoreen Herwaldt - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Infection control and hospital epidemiology, Vol.46(4), pp.384-390
- DOI
- 10.1017/ice.2024.233
- PMID
- 39949120
- PMCID
- PMC12015622
- NLM abbreviation
- Infect Control Hosp Epidemiol
- ISSN
- 1559-6834
- eISSN
- 1559-6834
- Publisher
- Cambridge University Press
- Grant note
- National Center for Injury Prevention and Control/CDC: R49 CE002108-05
This research was funded in part by grant #R49 CE002108-05 from the National Center for Injury Prevention and Control/CDC.
- Language
- English
- Electronic publication date
- 02/14/2025
- Date published
- 04/2025
- Academic Unit
- Infectious Diseases; Epidemiology; Orthopedics and Rehabilitation; Injury Prevention Research Center; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984787443302771
Metrics
5 Record Views