Patients with certain comorbidities who underwent TJA had increased risk of Staphylococcus aureus

ORLANDO, Fla. — Patients with diabetes, renal insufficiency and immunosuppression who underwent hip or knee replacement surgery had an increased risk of being colonized with Staphylococcus aureus and should be screened prior to surgery, according to results presented here.

“While this might not make a difference for people who are globally screening all their patients, it certainly might encourage people who do not screen all of their patients to at least screen these subset patient populations,” Amanda Walsh, MD, resident at The Mount Sinai Hospital, said in her presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.

Walsh and colleagues collected data, including age, gender, BMI, specific operative data and select comorbidities, from 716 patients who underwent hip or knee replacement surgery between 2011 and 2015. All patients had preoperative nasal swab results and treatment information, according to the researchers.

Overall, results showed an S. aureus colonization rate of 19.27%.

“In the subset of patients with diabetes, the colonization rate was 25.54%. In renal insufficiency, it was a high 37.5%. In immunosuppression, it was 26.9%,” Walsh said.

She noted 12.32% of colonized patients had immunosuppression. Compared with 17.61% of the uncolonized population, 25.36% of the colonized population had diabetes. Investigators found 6.52% of colonized patients had renal insufficiency vs. 2.43% of uncolonized patients.

Walsh added that, in a multivariate analysis, immunosuppression and renal insufficiency were independent predictors of nasal colonization. – by Casey Tingle

Reference:

Fields AC, et al. Paper #574. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla.

Disclosure: Walsh reports no relevant financial disclosures.