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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2020 | Hip-TEP | Research article

Prevalence of Staphylococcus aureus colonization in patients for total joint arthroplasty in South Africa

Authors: Jurek Rafal Tomasz Pietrzak, Zia Maharaj, Lipalo Mokete

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2020

Abstract

Background

Periprosthetic joint infections (PJIs) are a major source of morbidity and mortality for patients undergoing total joint arthroplasty (TJA). Staphylococcus aureus (S. aureus) colonization is an independent, modifiable risk factor for periprosthetic joint infections. Post-operative infections are reported to be ten times greater in S. aureus carriers than in non-carriers in developed countries though recorded data is lacking for the developing world. This study aims to determine the prevalence of S. aureus colonization in patients awaiting TJA in South Africa.

Methods

We prospectively assessed 119 patients awaiting total knee arthroplasty and total hip arthroplasty between May and October 2016. We screened three separate anatomical sites on each patient for S. aureus. Patients with positive cultures were treated with intranasal mupirocin ointment and chlorhexidine body wash. Univariate and comparative statistical analyses to determine risk factors for colonization was conducted using t tests, Fisher’s exact tests, and chi-square analyses.

Results

The overall prevalence of methicillin-sensitive S. aureus colonization was 31.9% (n = 38). There were no patients colonized with methicillin-resistant S. aureus. Nasal swabs returned a yield of 81.6% (n = 31), with groin swabs and axillary swabs at 39.5% (n = 15) and 28.9% (n = 11), respectively. Eradication was successful in 94.74% (n = 36) after 5 days treatment. All patients (100%) were decolonized after counseling and repeat eradication treatment. The overall complication rate was 7.6% (n = 9). The 30-day readmission rate in the S. aureus-colonized group was 7.9% (n = 3) as opposed to 7.4% (n = 6) in the non-colonized cohort. There were no 60- and 90-day readmissions and no cases were revised at a mean follow-up of 2.26 years.

Conclusions

The rate of S. aureus colonization in patients undergoing elective TJA in a developing country was 31.9% and is equivalent to reported rates in developed countries. Eradication treatment with combined intranasal mupirocin ointment and chlorhexidine body wash is a successful treatment modality. A larger cohort of patients is recommended to determine risk factors and post-operative septic sequelae in this population group.

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Title: Prevalence of Staphylococcus aureus colonization in patients for total joint arthroplasty in South Africa
Authors: Jurek Rafal Tomasz Pietrzak
Zia Maharaj
Lipalo Mokete
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Hip-TEP
Hip-TEP
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2020
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-020-01635-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prevalence of Staphylococcus aureus colonization in patients for total joint arthroplasty in South Africa

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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