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      Preoperative screening/decolonization for Staphylococcus aureus to prevent orthopedic surgical site infection: prospective cohort study with 2-year follow-up.

      The Journal of Arthroplasty

      Administration, Intranasal, Anti-Bacterial Agents, administration & dosage, therapeutic use, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee, Chlorhexidine, Cohort Studies, Follow-Up Studies, Hip Joint, microbiology, surgery, Humans, Knee Joint, Mass Screening, Mupirocin, Preoperative Care, methods, Prevalence, Prospective Studies, Retrospective Studies, Staphylococcal Infections, diagnosis, drug therapy, Staphylococcus aureus, isolation & purification, Surgical Wound Infection, epidemiology, prevention & control

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          Abstract

          We quantified surgical site infections (SSIs) after preoperative screening/selective decolonization before elective total joint arthroplasty (TJA) with 2-year follow-up and 2 controls. Concurrent controls (n = 2284) were patients of surgeons not participating in screening/decolonization. Preintervention controls (n = 741) were patients of participating surgeons who underwent TJA the previous year. Staphylococcus aureus nasal carriers (321/1285 [25%]) used intranasal mupirocin and chlorhexidine baths as outpatients. Staphylococcal SSIs occurred in no intervention patients (0/321) and 19 concurrent controls. If all SSIs occurred in carriers and 25% of controls were carriers, staphylococcal SSI rate would have been 3.3% in controls (19/571; P = .001). Overall SSI rate decreased from 2.7% (20/741) in preintervention controls to 1.2% (17/1440) in intervention patients (P = .009). Preoperative screening/selective decolonization was associated with fewer SSIs after elective TJA. Copyright © 2011 Elsevier Inc. All rights reserved.

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          21507604
          10.1016/j.arth.2011.03.014

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