Walsh A, et al. - Herein, patient risk factors for Staphylococcus aureus (S. aureus) nasal colonization were researched in a population of joint replacement patients. Findings revealed that 17.5% of patients undergoing primary hip or knee replacement surgery screened positive for S. aureus. Notably, risk factors for such colonization included diabetes, renal insufficiency, and immunosuppression. As recommended, patients with these comorbidities should be particularly screened and when necessary, decolonized, in view of these comorbidities being already established independent risk factors for periprosthetic joint infection.

Methods

• Researchers performed a retrospective review of a total of 716 patients undergoing hip or knee replacement beginning in 2011.
• They screened all patients preoperatively for nasal colonization.
• They used univariate and multivariate analyses to assess risk factors for nasal colonization.

Results

• Findings demonstrated that 716 patients undergoing joint replacement had preoperative nasal screening.
• Researchers found that 125 (17.50%) nasal swabs were positive for methicillin susceptible S. aureus (MSSA), 13 (1.80%) were positive methicillin resistant S. aureus(MRSA), and 84 (11.70%) were positive for other organisms.
• Predictors of nasal colonization with MSSA/MRSA included diabetes (p=0.04), renal insufficiency (p = 0.03), and immunosuppression (p=0.02), as demonstrated in bivariate analysis.
• Furthermore, independent predictors of nasal colonization with MSSA/MRSA included immunosuppression (p=0.04, OR: 2.0, 95% CI: 1.03-3.71) and renal insufficiency (p= 0.04, OR: 2.5, 95% CI: 1.01-6.18), as seen in multivariate analysis.