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Objective:The aim of this study was to evaluate whether the establishment of a preoperative screeningand decolonization protocol forStaphylococcus aureuscarriers undergoing total knee arthroplasty (TKA)could decrease the incidence of periprosthetic joint infection (PJI) caused by this microorganism.
Methods: We conducted a retrospective study comparing a control group comprising 400 patients (134men, and 266 women; mean age: 72.2±6.8 years) who went through surgery between January 2009and December 2013, with a second intervention group of 403 patients (125 men, and 278 women; meanage: 72.4±6.9 years) in which the protocol of screening and decolonization ofS. aureusnasal carrierswas applied between January 2014 and December 2016. During this latter period patients were preop-eratively screened and, if positive, treated with mupirocin nasal ointment and chlorhexidine soap, for 5days prior to surgery.
Results: In the control group, 17 of 400 patients (4.2%) had a SSI, 8 (2%) of them caused byS. aureusand 9(2.2%) by other microorganisms. In the intervention group 20.6% of patients had a positiveS. aureusnasalswab and were treated according to the protocol. 5 of 403 patients (1.2%) in this group had a SSI, 1 (0.2%)due toS. aureusand 4 (1%) to other microorganisms. When comparing surgical-site infection (SSI) ratesbetween the two groups, we found a statistically significant reduction in both global SSI (p¼0.009) andspecificallyS. aureusSSI (p¼0.02), in the intervention group. No decolonizedS. aureusnasal carrierpresented a SSI.
Discussion: In patients undergoing TKA a preoperative screening and decolonization protocol forS. aureusnasal carriers, using mupirocin nasal ointment and chlorhexidine soap, is an effective measureto reduce the rate of SSI caused by this microorganism.
Level of Evidence: Level III; Therapeutic Study.