Risk factors for Staphylococcus aureus surgical site infections after orthopaedic and trauma surgery in a French university hospital.


Journal

International journal of hygiene and environmental health
ISSN: 1618-131X
Titre abrégé: Int J Hyg Environ Health
Pays: Germany
ID NLM: 100898843

Informations de publication

Date de publication:
08 2020
Historique:
received: 17 01 2020
revised: 14 05 2020
accepted: 08 06 2020
pubmed: 12 8 2020
medline: 4 6 2021
entrez: 12 8 2020
Statut: ppublish

Résumé

Surgical site infections (SSI) after orthopaedic surgery are responsible for reduced quality of life, increased length of hospital stay and costs. The most commonly identified organism is Staphylococcus aureus but risk factors for S. aureus SSI are not well-known. The aim of this study was to evaluate the incidence rate trend of S. aureus SSI over the years and risk factors of these infections in a French University Hospital. SSI rates were expressed as cumulative incidence rates per year. A case-control study nested within a prospective cohort of patients undergoing orthopaedic or trauma surgery from January 1st Of 7438 interventions, 50 (0.7%) S. aureus SSI were identified, without significant increase by years. A total of 46 S. aureus SSI was matched to 91 controls. Risk factors for S. aureus SSI were smoking (odds-ratio (OR) = 8.4, 95%CI 1.2-59.6) and National Nosocomial Infections Surveillance System score (NNISS) ≥1 (OR = 5.8, 95%CI 1.8-19.1). Having 1 or 2 preoperative antiseptic showers (OR = 0.3, 95%CI 0.1-0.7) was a protective factor. The rate of S. aureus SSI is not negligible after orthopaedic and trauma surgery. It seems imperative to strengthen smoking cessation recommendations, and to recall the importance of preoperative antiseptic showers. Systematic screening and decolonization for S. aureus carriage before orthopaedic and trauma surgery could be a means to prevent these infections.

Sections du résumé

BACKGROUND
Surgical site infections (SSI) after orthopaedic surgery are responsible for reduced quality of life, increased length of hospital stay and costs. The most commonly identified organism is Staphylococcus aureus but risk factors for S. aureus SSI are not well-known. The aim of this study was to evaluate the incidence rate trend of S. aureus SSI over the years and risk factors of these infections in a French University Hospital.
METHODS
SSI rates were expressed as cumulative incidence rates per year. A case-control study nested within a prospective cohort of patients undergoing orthopaedic or trauma surgery from January 1st
RESULTS
Of 7438 interventions, 50 (0.7%) S. aureus SSI were identified, without significant increase by years. A total of 46 S. aureus SSI was matched to 91 controls. Risk factors for S. aureus SSI were smoking (odds-ratio (OR) = 8.4, 95%CI 1.2-59.6) and National Nosocomial Infections Surveillance System score (NNISS) ≥1 (OR = 5.8, 95%CI 1.8-19.1). Having 1 or 2 preoperative antiseptic showers (OR = 0.3, 95%CI 0.1-0.7) was a protective factor.
CONCLUSION
The rate of S. aureus SSI is not negligible after orthopaedic and trauma surgery. It seems imperative to strengthen smoking cessation recommendations, and to recall the importance of preoperative antiseptic showers. Systematic screening and decolonization for S. aureus carriage before orthopaedic and trauma surgery could be a means to prevent these infections.

Identifiants

pubmed: 32781428
pii: S1438-4639(20)30531-9
doi: 10.1016/j.ijheh.2020.113585
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

113585

Informations de copyright

Copyright © 2020 Elsevier GmbH. All rights reserved.

Auteurs

Virginie Forget (V)

Infection Control Unit, Savoie Hospital, Chambéry, France.

Jérôme Fauconnier (J)

Univ Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France; Medical Information, Public Health Department, Grenoble Alpes University Hospital, Grenoble, France.

Sandrine Boisset (S)

Bacteriology Laboratory, Grenoble Alpes University Hospital, Grenoble, France.

Patricia Pavese (P)

Infectious Diseases Unit, Grenoble Alpes University Hospital, Grenoble, France.

Céline Vermorel (C)

Univ Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France.

Jean-Luc Bosson (JL)

Univ Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France.

Dominique Saragaglia (D)

Department of Osteoarthritis and Sport Surgery, South Teaching Hospital, Grenoble Alpes University Hospital, Grenoble, France.

Jérôme Tonetti (J)

Department of Orthopaedic Surgery, Grenoble Alpes University Hospital, Grenoble, France.

Marie-Reine Mallaret (MR)

Univ Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France; Infection Control Unit, Public Health Department, Grenoble Alpes University Hospital, Grenoble, France.

Caroline Landelle (C)

Univ Grenoble Alpes, CNRS, Grenoble INP, TIMC-IMAG, Grenoble, France; Infection Control Unit, Public Health Department, Grenoble Alpes University Hospital, Grenoble, France. Electronic address: caroline.landelle@gmail.com.

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