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Bacterial colonization and resistance patterns in 133 patients undergoing a primary hip- or knee replacement in Southern Sweden.

Stefansdottir, Anna LU ; Johansson, Åsa LU ; Lidgren, Lars LU ; Wagner, Philippe LU and W-Dahl, Annette LU (2013) In Acta Orthopaedica 84(1). p.87-91
Abstract
Background and purpose Prosthetic joint infections can be caused by bacteria derived from the patient's skin. The aim of the study was: (1) to determine which bacteria colonize the nose and groin in patients planned for primary hip or knee arthroplasty, (2) to determine the antimicrobial resistance patterns, and (3) to monitor changes in bacterial colonization and resistance patterns connected to surgery. Patients and methods 2 weeks before scheduled primary hip or knee arthroplasty, culture samples were taken from the anterior nares and from the groin of 133 consecutive patients. At surgery, cloxacillin was given prophylactically and cement with gentamicin was used. 2 weeks after surgery, another set of samples were taken from 120 of... (More)
Background and purpose Prosthetic joint infections can be caused by bacteria derived from the patient's skin. The aim of the study was: (1) to determine which bacteria colonize the nose and groin in patients planned for primary hip or knee arthroplasty, (2) to determine the antimicrobial resistance patterns, and (3) to monitor changes in bacterial colonization and resistance patterns connected to surgery. Patients and methods 2 weeks before scheduled primary hip or knee arthroplasty, culture samples were taken from the anterior nares and from the groin of 133 consecutive patients. At surgery, cloxacillin was given prophylactically and cement with gentamicin was used. 2 weeks after surgery, another set of samples were taken from 120 of these patients. Bacterial findings and resistance patterns were analyzed. Results Preoperatively, 95% of the patients had coagulase-negative staphylococci (CNS) in the groin and 77% in the nose. The proportion of patients with a methicillin-resistant CNS in the groin increased from 20% preoperatively to 50% postoperatively (p < 0.001), and the proportion of patients with a gentamicin-resistant CNS in the groin increased from 5% to 45% (p < 0.001). 28% of the patients had Staphylococcus aureus in the nose preoperatively, and 7% in the groin. Methicillin-resistant Staphylococcus aureus (MRSA) was found in the nose of 1 patient. Interpretation In southern Sweden, beta-lactams were effective against 99% of the Staphylococcus aureus strains and 80% of the CNS strains colonizing the patients undergoing primary hip or knee arthroplasty. Gentamicin protects against most CNS strains in cemented primary joint replacements. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Orthopaedica
volume
84
issue
1
pages
87 - 91
publisher
Taylor & Francis
external identifiers
  • WOS:000314897500016
  • PMID:23409844
  • Scopus:84873935598
ISSN
1745-3682
DOI
10.3109/17453674.2013.773120
language
English
LU publication?
yes
id
87336fb5-73d2-4557-952b-af11b7b7bb43 (old id 3559774)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23409844?dopt=Abstract
date added to LUP
2013-03-04 13:11:51
date last changed
2016-11-11 11:16:25
@misc{87336fb5-73d2-4557-952b-af11b7b7bb43,
  abstract     = {Background and purpose Prosthetic joint infections can be caused by bacteria derived from the patient's skin. The aim of the study was: (1) to determine which bacteria colonize the nose and groin in patients planned for primary hip or knee arthroplasty, (2) to determine the antimicrobial resistance patterns, and (3) to monitor changes in bacterial colonization and resistance patterns connected to surgery. Patients and methods 2 weeks before scheduled primary hip or knee arthroplasty, culture samples were taken from the anterior nares and from the groin of 133 consecutive patients. At surgery, cloxacillin was given prophylactically and cement with gentamicin was used. 2 weeks after surgery, another set of samples were taken from 120 of these patients. Bacterial findings and resistance patterns were analyzed. Results Preoperatively, 95% of the patients had coagulase-negative staphylococci (CNS) in the groin and 77% in the nose. The proportion of patients with a methicillin-resistant CNS in the groin increased from 20% preoperatively to 50% postoperatively (p &lt; 0.001), and the proportion of patients with a gentamicin-resistant CNS in the groin increased from 5% to 45% (p &lt; 0.001). 28% of the patients had Staphylococcus aureus in the nose preoperatively, and 7% in the groin. Methicillin-resistant Staphylococcus aureus (MRSA) was found in the nose of 1 patient. Interpretation In southern Sweden, beta-lactams were effective against 99% of the Staphylococcus aureus strains and 80% of the CNS strains colonizing the patients undergoing primary hip or knee arthroplasty. Gentamicin protects against most CNS strains in cemented primary joint replacements.},
  author       = {Stefansdottir, Anna and Johansson, Åsa and Lidgren, Lars and Wagner, Philippe and W-Dahl, Annette},
  issn         = {1745-3682},
  language     = {eng},
  number       = {1},
  pages        = {87--91},
  publisher    = {ARRAY(0xa40ed40)},
  series       = {Acta Orthopaedica},
  title        = {Bacterial colonization and resistance patterns in 133 patients undergoing a primary hip- or knee replacement in Southern Sweden.},
  url          = {http://dx.doi.org/10.3109/17453674.2013.773120},
  volume       = {84},
  year         = {2013},
}